Diagnosis, Karen. Diagnosis.

Well, I had so much hope that when Karen identified her “new pathology” as a Dissociative Identity Disorder (multiple personality) that she had finally returned to established constructs for describing pathology – you know, the ideas and terms that EVERYBODY else in professional psychology uses.

I was wrong.  She’s wandering back into her grandiosity on her more recent blog, again.  She is using professional terms incorrectly – not in their established definitions.  In doing that, she is creating confusion.  She needs to stick to reality. (Karen’s blog).

A fixed and false belief that is maintained despite contrary evidence.  In the case of elevated self-opinion “without commensurate background” it would be considered a grandiose delusion.  Did I mention that grandiose delusions are associated with two pathologies, a grandiose delusion is a “mood-congruent” psychotic delusion in mania, so a biplolar disorder with psychotic features is one place they occur, and a grandiose delusion is associated with narcissistic personality pathology.

From Millon:  “Free to wander in their private world of fiction, narcissists may lose touch with reality, lose their sense of proportion, and begin to think along peculiar and deviant lines.” (Millon, 2011, p. 415)

Millon. T. (2011). Disorders of Personality: Introducing a DSM/ICD Spectrum from Normal to Abnormal. Hoboken: Wiley.

Karen is not only wandering in the world of making up new forms of pathology, she’s now starting to make up new forms of treatment for the new forms of pathology she’s making up.  She’s entirely making everything up, just her, making stuff up.  Listen to her.  She’s making up a new pathology, entirely on her own, and now she’s making up a new treatment for this new pathology she’s making up, entirely on her own.

That’s not professional practice, Karen.  In professional practice, we apply knowledge, we don’t simply make it up on our own because our ideas make us feel warm and fuzzy.  Karen, however… appears to believe she is exempt from this requirement for applying knowledge, and instead considers herself entitled to make up new pathologies and new treatments entirely on her own, because I guess she believes that truth and reality are whatever she asserts them to be.

No, Karen, there is actual truth and there is actual reality.  We’re leaving Wonderland, Karen.  No more summer croquet parties on the lawn, no more afternoon tea with friends, no more hookah smoking caterpillars pontificating about the world.  Reality Karen.  There is an actual reality.

Karen, have you ever heard of the concept of diagnosis?   Serious question, Karen.  Have you ever heard of diagnosis?  Because you are nowhere close yet to actually diagnosing the pathology you’re treating.

Say you have a bad tummy pain and go to your doctor? Does the doctor diagnose you with this new pathology that the doctor is just discovering, Tummy Pain Disorder, or do they diagnose you with Appendicitis?  Does your doctor then treat you with a new form of therapy they’ve created for Tummy Pain Disorder, or does your doctor treat you for Appendicitis?

Which would you prefer as a patient, Karen?  Would you like your physician to diagnose and treat your Tummy Pain Disorder with a new treatment, both of which your doctor just created, or Appendicitis with established treatment?  I think most humans who live in reality would prefer a real diagnosis and real treatment.

But you like your Tummy Pain Disorder, don’t you, Karen.  What are you calling it? Traumatic Spitting, a dissociative identity disorder of a “split” personality – it’s called an Dissociative Identity Disorder by every other mental health professional on the planet, except you Karen.  Do you think that might be a tad confusing for people, when you don’t use professional language in any agreed-upon definitions within professional psychology, but just kind of go making up your own definitions for the words that already HAVE definitions, just not the ones you’re using, do you think that will add to clarity… or confusion?

You know who Aaron Beck is, right Karen, the guy who’s the the grand-high kahuna of CBT therapy?  He’s also heavily involved in CBT cognitive therapy for personality disorders.  Linehan is over in the CBT model with her Dialectic Behavior Therapy for borderline personality pathology.  Listen to what Beck says about the sense of entitlement surrounding narcissistic pathology

From Beck:  “Another conditional assumption of power is the belief of exemption from normal rules and laws, even the laws of science and nature.” (p. 251-252)

Beck, A.T., Freeman, A., Davis, D.D., & Associates (2004). Cognitive therapy of personality disorders. (2nd edition). New York: Guilford.

“exemption from normal rules” – like diagnosis, Karen?

Are you exempt from diagnosing your patients, Karen?  You’re creating a new pathology, you are not diagnosing your patients.  Upset Tummy Disorder is not a replacement diagnosis for Appendicitis.  And creating new therapies when you haven’t even diagnosed the pathology first is extremely questionable professional practice, Karen.

Have you ever heard of diagnosis?  What is the DSM-5 or ICD-10 diagnosis for this “Traumatic Splitting” pathology you’re creating, Karen, your Tummy Pain Disorder?

But, hey, I’m never adverse to a stroll through Wonderland, we always meet such interesting characters, let’s see who we’ll meet on this stroll.  So let’s just walk along with Karen for awhile, shhh, let’s not disrupt her grandiose delusion, she’s having such fun with it.  Not only does it allow her to make up diagnoses willy nilly, apparently she feels entitled to make up treatments now willy nilly too.  She’s having such good fun.

Now, that’s special, developing new treatments for new pathologies she thinks she’s “discovering.”  Oh my goodness.   In developing a “new treatment” for a “new pathology” that she’s “discovering,” Karen Woodall enters the pantheon of the most elite figures of professional psychology who described new pathology and developed new forms of therapy; Sigmund Freud, Carl Rogers, B.F. Skinner, Aaron Beck. Salvador Minuchin… and Karen Woodall.

Thanks so much, Karen.  We needed a new form of psychotherapy. The psychotherapy we had from all of the previous great minds of professional psychology simply weren’t enough… we needed you.  Thank you for bestowing your magnificence upon us, Karen, and for leading all of professional psychology from the darkness of our ignorance into the magnificence our your brilliance.

Thank you, Karen.

DSM-5 Narcissistic Personality Disorder Criterion 3: “Believes that he or she is “special” and unique.”

That’s quite a special thing you’re doing for all of us, Karen, discovering this pathology that no one has ever seen before, and then developing a new therapy for it.  My, that seems like such hard work.  Thank you Karen.  I don’t think there’s anyone else who could have understood this pathology at such depth, wow, you’re special, and to develop a whole new form of therapy, like Freud and psychoanalysis or Minuchin and family systems therapy, or Aaron Beck and CBT… and now you, Karen Woodall.  Wow.  You’re like… unique, aren’t you.  Well maybe not totally unique, you’re like Freud or Minuchin or Beck unique.  One of the elite of all time.

DSM-5 Narcissistic Personality Disorder Criterion 4: Requires excessive admiration.

Thank you, Karen. Thank from all of professional psychology for coming to our rescue in our darkness and ignorance.  We needed you, and you came.  I can’t tell you how grateful we all are to have your magnificence, Karen.  I don’t think there’s another person on that planet would could have “discovered” this new pathology of… what is it again?  Right, Traumatic Splitting.

DSM-5 Narcissistic Personality Disorder Criterion 5: Has a sense of entitlement.

Question.  Karen.  Have you ever heard of this concept called “diagnosis”?  The application of established knowledge to a set of symptoms.  Diagnosis.

Now, I really appreciate what you’re doing for all of us here in professional clinical psychology and all, developing these wonderful new insights into this new form of pathology, and coming up with these new forms of treatment entirely on your own.  That’s great.  Thanks so much for doing that, and for leading us all out of the darkness of our ignorance and into your light made manifest before us as you spread your magnificence with all the world.

Thanks for that, great job, only you could be so wonderful, thanks for saving us.

But my question… have you ever heard of diagnosis?  You know, applying established constructs to a set of symptoms.  Like say… the DSM-5.

You see, with the DSM-5 we stay anchored in symptoms.  We don’t go wandering into worlds of strange stuff, anybody’s strange stuff, not even Freud’s, or Skinner’s, or Minuchin’s.  No one’s theories.  It’s all anchored on symptoms.  That’s what diagnosis is, ever heard of it?

Like for Major Depression.  The DSM-5 lists 8 symptoms for a depressive episode.  If the patient displays five of the eight, then they have a DSM-5 diagnosis of Major Depressive Disorder.  Six of nine symptoms of hyperactivity, the child has ADHD.  Five personality disorder traits, that’s a personality disorder.  See how that works, that diagnosis thing.

There’s a certain set of symptoms specified, “operationally defined” it’s called, and then there is a specified cutoff identified, a criterion number of symptoms needed for the diagnosis.  Below that number – no diagnosis.  Above that number – diagnosis.

Anywhere close to that with your “Traumatic Splitting” disorder there, Karen?  You know, identifying the symptom set and the cutoff criteria… oh, and the research base.  New pathology proposals require research bases like ADHD and autism.  I’m looking forward to yours to support this new Traumatic Splitting dissociative identity pathology you’re proposing.

It’s all symptom driven, diagnosis is.  That’s what makes it so wonderful in anchoring us.  What are the symptoms?  We always start by identifying, with a fair degree of operationally defined specificity, the symptoms.  If all psychologists and mental health people are going to reliably identify a symptom, it has to be described with enough specificity that we call all do that, all the time.  That’s important with diagnosis.  If our symptom descriptions allow too much latitude for interpretation, then our diagnostic model collapses.

Like for a Narcissistic Personality Disorder, DSM-5 Criterion 1…

DSM-5 Narcissistic Personality Disorder Criterion 1:  Has grandiose sense of self-importance

What’s a “grandiose sense”?  Well, that could be open to interpretation.  Me, for example, I think I am an exceptionally good clinical psychologist.  Is that grandiose, or just self-confidence?  But say I thought I was discovering some new scientific breakthrough that wasn’t really a breakthrough, it was just me making stuff up and thinking I was “discovering” something, would that be a “grandiose sense” of my own self-importance?  If I thought everybody needed to listen to me because of my special “new discovery” I’m making up, now I’m not simply claiming to be just a good psychologist, I’m a wonderfully special psychologist apart from other ordinary everyday kinds of psychologists, I’m superior, like I’m some kind of “expert” or something.  Would I have a “grandiose sense” of my own self-importance then?

So you can see where some degree of interpretation comes into the symptom’s identification, but the DSM-5 provides a clear set of symptoms, as clear as they can possibly be made (that’s why they provide a lot of descriptive comment in the text for each diagnostic pathology and a huge research base that the diagnostician can refer to for understanding the symptom features of the diagnostic label).

So Karen, what we do with diagnosis is we start with some structured diagnostic model, most people use the DSM system of the American Psychiatric Association, or the ICD system of the World Health Organization is also commonly used.   The American Psychiatric Association and WHO have worked together to mostly line up the two diagnostic systems, the DSM and ICD, there’s only a few, but important, discrepancies.  For example, the ICD has a diagnosis for a Shared Delusional Disorder, F24, but the DSM does not, they dropped their diagnosis of a shared delusional disorder from the DSM-5 that they previously had in the DSM-IV.

That’s a subtle, but very important difference in the DSM and ICD systems.  The ICD diagnostic system of the World Health Organization assigns all professionally established medical and psychiatric diagnoses a code number.  So it’s sort of the grand-bible of all recognized medical and psychiatric pathologies, each one has a code number. The ICD-10 has a code for a shared delusional disorder; F24… and, here’s the interesting thing, the ICD-10 diagnostic system is THE required diagnostic system for ALL insurance billing in the United States.

All insurance billing requires an ICD-10, not a DSM-5 diagnosis.  That switched over that way a few years ago.  Before that, before the switch, the U.S. used the DSM system and Europe used the ICD system.  The ICD system though, also covers all medical pathologies like cancer and heart disease diagnoses, everything, all possible medical and psychiatric pathologies… that’s the ICD.   The DSM is just psychiatric.  But because it’s from the American Psychiatric Association, the DSM diagnostic system provides a more fully identified and more fully described set of diagnostic pathologies.  The ICD describes a diagnostic category in one or two paragraphs, the DSM describes the diagnostic pathology in five or ten pages.

Insurance billing for medical diagnoses has always used the ICD system, because that’s a comprehensive system for identifying all types of medical diagnoses.  But in the U.S. the insurance companies went American and used the American Psychiatric Association DSM diagnostic codes for billing the treatment of mental health diagnoses.  Well, somewhere a decade ago or so, the insurance companies finally said enough, we’re switching to the ICD for all coding of diagonses.  They gave everyone plenty of warning, so the ICD and DSM set about lining up their codes.  The rollout of a partial switch happened with the ICD-9, and a full switch to the ICD-10 was mandatory for all insurance billing for mental health pathology.

So in the U.S. and in Europe, all mental health professionals have diagnostic access to the ICD-10 diagnosis of F-24, a shared delusional disorder, and since there is no current corresponding diagnostic category in the DSM-5 for that ICD-10 code, that means we should turn to the DSM-IV when this diagnostic category WAS still in the DSM system.  The DSM diagnostic system of the American Psychiatric Association had a diagnostic category corresponding to an ICD-10 diagnosis of a shared delusional disorder, but they dropped it for the DSM-5, they moved it to a “specifier” rather than a stand-alone diagnostic category, which essentially makes it diagnostically inaccessible in actual practice.

But a shared delusional disorder was in the DSM-IV, it’s called a Shared Psychotic Disorder.  Listen to this description of the diagnostic pathology by the American Psychiatric Association.

From the DSM-IV:  “The essential features of Shared Psychotic Disorder (Folie a Deux) is a delusion that develops in an individual who is involved in a close relationship with another person (sometimes termed the “inducer” or “the primary case”) who already has a Psychotic Disorder with prominent delusions (Criteria A).” (p. 332)

That fits this pathology, doesn’t it?  The allied parent has the persecutory delusion (the primary case; the “inducer”) and the child is the secondary case and acquires the persecutory delusion from the allied parent.  A parent-child relationship qualifies as a “close relationship,” so far so good.

From  the DSM-IV:  “Usually the primary case in Shared Psychotic Disorder is dominant in the relationship and gradually imposes the delusional system on the more passive and initially healthy second person. Individuals who come to share delusional beliefs are often related by blood or marriage and have lived together for a long time, sometimes in relative isolation.” (p. 333)

Still fits.  The allied parent, the “primary case,” is in a dominant parental role with the child, “gradually imposes” yes, that’s exactly what’s happening, “more passive and initially healthy” that’s the child, yes still fits, “often related by blood” yes, “and have lived together for a long time” yes, in “relative isolation” in the family, yes.  So we’re still spot-on in the diagnostic pathology description.

Now here’s an interesting statement from the American Psychiatric Association because it carries treatment implications.  It was a communication from the diagnostic committee of the American Psychiatric Association to the diagnosing professionals… if you’re seeing this pathology, this is what typically helps…

From the DSM-IV:  “If the relationship with the primary case is interrupted, the delusional beliefs of the other individual usually diminish or disappear.” (p. 333)

A protective separation of the child from the “primary case” of the persecutory delusional pathology is the treatment recommendation offered by the American Psychiatric Association for a shared delusional disorder.  Works for me. I’m not going to argue with the American Psychiatric Association when they come up with their diagnoses.  You tell me.  I apply the criteria to make a diagnosis.

From the DSM-IV:  “Although most commonly seen in relationships of only two people, Shared Psychotic Disorder can occur in larger number of individuals, especially in family situations in which the parent is the primary case and the children, sometimes to varying degrees, adopt the parent’s delusional beliefs.” (p. 333)

A shared delusion can occur “especially in family situations” we still have a complete fit of diagnosis pattern, “in which the parent is the primary case” yes, “and the children, to varying degrees, adopt the parent’s delusional beliefs” yes.

We have a full and complete fit for this child-family pathology with the diagnostic description provided by the American Psychiatric Association.  Diagnosis is symptom-driven, not theory driven.  There are no theories in the DSM, there are symptoms and diagnostic categories for defined patterns of symptoms.

But let’s look even further at what the American Psychiatric Association says about exactly this pathology;

From the DSM-IV Associated Features and Disorders:  “Aside from the delusional beliefs, behavior is usually not otherwise odd or unusual in Shared Psychotic Disorder.” (p. 333)

Yes, the child is functioning okay at school, there’s no overt or “otherwise odd or unusual” behavior from the parent or child.  The diagnostic description still fits exactly, without deviation from the description for a shared delusional disorder diagnosis in the DSM-IV.

From the DSM-IV:  “Impairment is often less severe in individuals with Shared Psychotic Disorder than in the primary case.” (p. 333)

The allied parent is more pathological than the child, yes.

From the DSM-IV:  Prevalence:  “Little systematic information about the prevalence of Shared Psychotic Disorder is available. This disorder is rare in clinical settings, although it has been argued that some cases go unrecognized.” (p. 333)

Yes, all of court-involved family conflict has gone “unrecognized” – yes.

From the DSM-IV Course: “Without intervention, the course is usually chronic, because this disorder most commonly occurs in relationships that are long-standing and resistant to change.” (p. 333)

Again, spot on.  The parent-child conflict with the targeted parent is “chronic,” “long-standing,” and “resistant to change,” yes, yes, yes.

According to the American Psychiatric Association, this pathology MUST receive treatment and it will NOT be resolved by waiting for something to change.

So… American Psychiatric Association, any recommendations about treatment?

From the DSM-IV:  “With separation from the primary case, the individual’s delusional beliefs disappear, sometimes quickly and sometimes quite slowly.” (p. 333)

So you, the American Psychiatric Association, are recommending a protective separation of the child from the “primary case” in a shared delusional disorder diagnosis, that’s what you, the American Psychiatric Association are recommending for treatment?  A protective separation.  The American Psychiatric Association.

If this pattern of symptoms lines up with the symptoms being displayed, you’re saying, the American Psychiatric Association is saying, that there MUST be treatment or else the situation will remain “chronic,” “long-standing,” and “resistant to change,” and that the treatment should be the child’s protective “separation from the primary case” – the treatment recommendation of the American Psychiatric Association for a DSM-IV diagnosis of a shared parent-child delusional disorder is the child’s protective separation from the “primary case” of the allied narcissistic-borderline parent.

Karen.

The DSM-IV was superseded by the DSM-5 in 2013.  Remember that?  Sure you do.  Bill Bernet and you, and all the Gardnerian PAS “experts” were putting on a major push to the American Psychiatric Association, trying to get your beloved Gardnerian “parental alienation” pathology mentioned somewhere, anywhere, in the DSM-5.  You just wanted them to use the word somewhere.  So you presented them with all your decades-long “research” and your diagnostic proposals for the pathology.

Remember that?  By the way, what’d they say? Oh, that’s right, “No.”

Do you remember what I was arguing back in that 2012 run-up period to the DSM-5.  I was seriously concerned that they were going to monkey with the Narcissistic personality category, which they ALMOST did, the new proposal for personality disorders went into an Appendix, whew, that was close – and I was also arguing that we needed to keep the Shared Delusional Disorder diagnosis.  That we should be focused on that diagnosis, on keeping that DSM diagnosis.  Remember that?

That was where we should have been putting our focus with the DSM-5, not on some “new pathology” – I mean seriously, holy cow – look at that Shared Delusion diagnosis, spot-on every criteria, leading to a protective separation recommendation made by the American Psychiatric Association.  The moment we – as mental health professionals – give that diagnosis, the moment we do that, the American Psychiatric Association makes a treatment recommendation for the child’s protective “separation from the primary case” BASED on our diagnosis.  Wow.  Simple.  Give that diagnosis.  It absolutely 100%  applies criteria-by-criteria, give that DSM-IV diagnosis and immediately get a recommendation from the American Psychiatric Association for a protective  “separation from the primary case” based – based – on my diagnosis.

That is immense power in diagnosis alone.  Karen, isn’t that amazing?  If you had just been diagnosing the pathology, think of all the wonderful things.

But, instead, your Gardnerian PAS “experts” group led by Bill Bernet went all-in on “parental alienation” and we lost the Shared Delusional pathology from the DSM-5, it got shifted to a “specifier” rather than a diagnosis, and we lost all the descriptive information about the pathology.  Shame.

You know when the American Psychiatric Association told you “No” to your new pathology of “parental alienation” idea, they’re telling you something, Karen.  You’re not listening.  They are telling you that diagnostically, whatever you think you have going on… it’s already in the DSM.  Already there.  You’re just not doing a good diagnostic job.  That’s what they’re telling you, Karen.  You are a bad diagnostician, the pathology you think you’re “discovering” is already in the DSM – you’re just a bad diagnostician.

Go back to the symptoms, and organize them up by DSM category.  You can do that, right Karen?  Not by your willy nilly ideas.  Organize the symptoms into the patterns described in the DSM diagnostic system, and if the symptoms line up with something, give that diagnosis.  And you see, there is it, Karen, it IS in the DSM after all.  You just weren’t doing your job of diagnosis.

You skipped the step of diagnosis.  Instead of diagnosing the pathology, you went running off into your fertile imagination of creating “new” pathologies.

And yet… and here is the truly disturbing part… you treated the pathology, without having first diagnosed the pathology. Oh my goodness, Karen, you DO realize that the treatment for cancer is different than the treatment for diabetes, don’t you? How can you possibly treat a pathology when you haven’t even first diagnosed what it is you’re treating?

That’s insane, Karen.  To treat a pathology you haven’t even diagnosed yet.  You have no idea what it is you’re even treating.

No, that can’t be.  That’s absurd.  You would NEVER treat a pathology for 20 years without EVER having diagnosed what the pathology is that you’re treating.  That’s laughable.  You’d never do that.  The treatment for cancer is different than that treatment for diabetes, you’d never just start treating something without first diagnosing what it is.

You’ve clearly been using the DSM-IV diagnosis of a Shared Psychotic Disorder extensively during your work, first as a DSM-IV diagnosis and now as an ICD-10 diagnosis.

So, let’s see, the DSM-IV came out in 2000, the DSM-5 in 2013, so the active period for the DSM-IV and the Shared Psychotic Disorder diagnosis was from 2000 to 2013 and you’ve been twenty years treating this court-involved family conflict stuff, so pretty much the entire time you’ve been treating this pathology, the DSM-IV was the active diagnostic system.

And oh my goodness, the spot-on accurate diagnosis of a Shared Psychotic Disorder is right there, in the DSM-IV, and it makes a recommendation, from the American Psychiatric Association for a protective “separation from the primary case” – what’s your clinic called, Karen, oh, that’s right, the Separation Clinic – and the APA is saying… authorizing you, Karen Woodall, to recommend a protective separation of the child from the “primary case” of a shared persecutory delusional disorder, because that’s what the American Psychiatric Association recommends based on your diagnosis Karen in applying their diagnostic criteria from the DSM-IV.

So clearly and obviously you’ve been diagnosing this pathology as a Shared Psychotic Disorder pretty much your entire career, haven’t you?  Because you wouldn’t start treating something that you hadn’t even diagnosed yet? That’s absurd. No one would do that.  Would your physician just start treating you for something without having first diagnosed what’s wrong.  That’s an absurd suggestion.  No rational human would do that, just start treating something without having diagnosed it first.  My goodness gracious, the treatment for cancer is different that the treatment for diabetes.  No one would do that.

So… if the diagnostic entity of a Shared Psychotic Disorder has been in existence your entire career working with this pathology, first as a DSM-IV diagnosis and now as an ICD-10 diagnosis, I’m sure you’ve made this diagnosis countless times, and argued on behalf of your clients, the targeted parents, countless times that a protective “separation from the primary case” of the shared persecutory delusional disorder is the treatment recommendation from the American Psychiatric Association for your diagnosis.

Haven’t you.  Sure you have.  You must have.  Because you wouldn’t possibly treat something you haven’t even diagnosed yet. That’s absurd, nobody treats something without first diagnosing what it is they’re treating.  So you must have used this DSM-5 and ICD-10 diagnosis countless times before, right Karen.

What’s been the response when you share the protective separation recommendation of the American Psychiatric Association for your diagnosis?  I’ll bet your targeted parent clients really appreciated getting that diagnosis from you, didn’t they.  Must of helped them a lot when they went to seek a protective separation order from the court, to have your DSM-IV or ICD-10 diagnosis of a Shared Psychotic Disorder and the recommendation of the American Psychiatric Association for a protective separation order based on your DSM-IV or ICD-10 diagnosis.

I’ll bet your targeted parent clients were pretty happy about that, weren’t they Karen.

All you have to do is give the diagnosis, Karen, and immediately the power of the American Psychiatric Association recommending the child’s protective “separation from the primary case” becomes available to you and to the targeted-rejected parent.  So surely you must have given this DSM-IV diagnosis countless times across your 20-year career that spans the exact period of this diagnosis in the DSM-IV, a Shared Psychotic Disorder.

I’m sure you’ll agree, Karen, lucky for us the ICD-10 kept the diagnosis of a Shared Psychotic Disorder, F24.  Whew.  Now we just give that ICD-10 diagnosis, and since there isn’t a corresponding diagnosis in the DSM-5, we turn to the corresponding description from the DSM-IV for this pathology, and we still maintain our access to the DSM-IV descritors for the pathology.  Whew, that was close, wasn’t it Karen.  I’ll bet you’re as relieved about that as I am.

As you remember, Karen, I only became active over here with this court-involved family conflict pathology starting around the 2012 period, at the time I was posting a lot of stuff to my website on the personality disorder linkages, that’s what I was unlocking during that 2012 period.  You can still see all my early stuff up on my website, I posted the DSM-IV Shared Psychotic Criteria to my website.  It’s still up there:

DSM-IV TR Shared Psychotic Disorder Criteria

I leave everything I post up there, so if I’m posting DSM-IV TR diagnostic criteria, you know this is pre-2013 when the DSM-5 came out.

So you can see how I come over here to this pathology and I immediately start hitting the DSM-IV diagnosis of a shared delusional belief, a Shared Psychotic Disorder.  I’m a little worried by the intensity of the diagnostic label as “Psychotic” – it is, but it can be disorienting to someone unfamiliar with psychosis – it’s not running around crazy lunatic psychosis, it’s more contained, it’s a delusion, a false and distorted thinking pattern, persecutory, jealousy delusions, eroto-manic (the movie-star stalker).  An encapsulated pocket of delusional belief that’s shared between two people in a close relationship, the “primary case” creates the shared delusion in the secondary case, the formerly healthy person.

So no sooner than I get over here than I’m starting to highlight the DSM-IV pathology of the shared delusional disorder.   It’s a diagnosis.  I give every patient a diagnosis.  How can I possibly develop a treatment plan if I don’t know what I’m treating.  That is absurd.  So obviously I start with a diagnosis, and I have a DSM-IV diagnosis of Shared Psychotic Disorder spot-on describing this pathology, and with a protective “separation from the primary case” of the allied parent as the treatment-oriented recommendation of the American Psychiatric Association for my diagnosis.

I’m the one making the diagnosis.  There is no “peer review” of my DSM-IV diagnosis – apply the DSM criteria to symptoms, pattern match, make the diagnosis.  Pretty goll darn straightforward.

What’s forensic psychology’s malfunction about diagnosis? Oh, they openly say, “We don’t diagnose anything (identifying what the problem is) because we don’t like placing labels on people.”   Well that’s the nuttiest thing I ever heard.   We’ll have to address their nuttiness around diagnosis at some point.

You do realize mental health people, that we are mental health people, we’re the ones who are supposed to be diagnosing pathology.   Plumbers aren’t.  They’re supposed to fix our plumbing.  Attorneys aren’t.  They argue our cases for us in court.  Hmmm, who is it that’s tasked with the professional obligation of diagnosing pathology, oh, right, the mental health professional.

So if I’m starting with this DSM-IV diagnosis back in 2010-2012, and you’ve already been here and been established with your Separation Clinic, Karen, for what, ten years by that point.  So clearly you’ve been using this DSM-IV diagnosis lots and lots by that point.   Because, holy cow, Karen, the American Psychiatric Association is recommending a protective “separation from the primary case” based solely on your diagnosis.  If someone challenges your diagnosis, they’re welcome to get a second opinion.  Our diagnosis is our diagnosis.  We apply criteria, we match pattern, we make diagnosis.

You know that, Karen.  You know the power we have in diagnosis, right?  You do diagnose pathology, right Karen?

You see how I walked through step-by-step, sentence-by-sentence, the diagnostic descriptions of the DSM-IV.  It all applies spot-on.  So clearly, Karen, as an “expert” in this pathology with 20 years of experience that spans the exact period of the DSM-IV and the Shared Psychotic Disorder, you surely have given this DSM-IV diagnosis countless times, and argued for a protective separation of the child from the “primary case” of the shared perscutory delusional disorder, the allied parent, many-many times, based on the treatment recommendations made by the American Psychiatric Association based on your diagnosis, right Karen?  .

So tell us, what was it like to apply this DSM-IV diagnosis, what happened?  Because surely you wouldn’t treat a pathology without having first diagnosed what it is, the treatment for cancer is entirely different than the treatment for diabetes, so that’s just absurd that you would skip diagnosing a pathology and would just jump into treating something that you had no idea what it even was.  So you clearly have been applying the diagnosis of a Shared Psychotic Disorder a lot.

It’s still in the ICD-10 too, F24.  Lucky for us and targeted parents, right Karen.  So now we can keep using it as our formal diagnosis by just switching to the ICD-10 system and referencing back to the DSM-IV (because there’s no corresponding DSM-5 diagnosis for ICD-10 F24 Shared Psychotic Disorder).

Whew, I think you’ll agree with me that we’re lucky the ICD-10 kept the Shared Psychotic diagnosis.  I’ll bet targeted parents are thrilled when you tell them, that based on our diagnosis alone, the American Psychiatric Association will recommend the child’s protective separation from the allied narcissistic-borderline parent.  They must be so happy to hear that.

Because, as you and I both know, it’s all based on our diagnosis.  You do know how to diagnose something, don’t you Karen?  I mean, you wouldn’t treat something for twenty years without ever having diagnosed what it is you’re treating.

I see you’ve been traveling a lot, talking to people, educating them about this pathology.  That’s great.  Tell us, what’s been their reaction when you tell them about the ICD-10 diagnosis and protective separation recommendation of the APA based solely on your individual diagnosis.  Pretty excited I bet.  What about when you tell them that if they apply the three diagnostic criteria of AB-PA that are grounded in Bowlby, Minuchin, Beck, then the DSM-5 diagnosis – our current DSM- the DSM-5 diagnosis is V995.51 Child Psychological Abuse, Confirmed.  I’ll bet they go through the roof with excitement when you tell them that.  You do tell them that the pathology is diagnosable using the DSM-5 and AB-PA as Child Psychological Abuse, don’t you?.

They must be so excited to hear that.  What’s been their response when you tell them about the Shared Psychotic Disorder diagnosis and the Child Psychological Abuse diagnosis available through AB-PA?  I can only imagine their excitement at hearing about this.

Imagine… all this time people have been saying this “parental alienation” pathology isn’t in the DSM-IV or DSM-5.  Of course it is, right Karen.  In the DSM-IV it was a Shared Psychotic Disorder, and in the DSM-5 it’s Child Psychological Abuse, page 719.  Boy, I’ll bet they are so happy to hear that when you explain that to them. Of course the pathology is already in the DSM, we just have to diagnose it properly, right Karen.

But… I’m confused, Karen.  If they’ve been saying “parental alienation” is not in the DSM all this time, and you’ve known that it is actually in the DSM this whole time, as a shared delusion of a Shared Psychotic Disorder, why didn’t you clear up their confusion? Of course it’s in the DSM-IV, it’s a Shared Psychotic Disorder. Why didn’t you say something, Karen?

You do know how to diagnose pathology, right Karen? And you certainly wouldn’t start treating something before you diagnosed what it was, right Karen?  So why didn’t you correct them and point out that this pathology is in the DSM-IV, as a shared delusional disorder, with the American Psychiatric Association recommending a protective separation of the child from the allied “primary case” of the persecutory delusion?  What did they say when you pointed that out to them, Karen, that it IS in the DSM-IV?

Or does your role as a grandiose self-appointed “expert” in a supposedly new form of pathology exempt you from the requirements of diagnosis, Karen?  You’re special because of your special knowledge, you’re not bound by the same standards of professional practice for diagnosis as everyone else, us average psychologists, because you’re an “expert” – you get to skip actually diagnosing pathology, you get to just make up stuff… because.  Because you’re just entitled to do that, right Karen.

These people you’re educating on your travels must be so excited when you tell them about diagnosis.  I can imagine their amazement when they learn that this power of our diagnosis, that we’ve had it this whole time.  Wow, that must be something, when they hear that.

You do diagnose before you treat pathology, don’t you Karen? Tell me that you do diagnose a pathology before you begin to treat it – DSM-5; ICD-10.

And seriously, Karen, isn’t that American Psychiatric Association recommendation for a protective separation from the “primary case” wonderful.  You and I both know how useful that can be for targeted parents in presenting their cases to the court, to have a direct quote from the American Psychiatric Association recommending a protective “separation from the primary case” based solely on your DSM-IV/ICD-10 diagnosis of F24 Shared Psychotic Disorder.

Everyone must be so excited when you tell them this about diagnosis.  But you’ve known all this all along, haven’t you Karen.  Because you certainly wouldn’t treat a pathology that you haven’t even diagnosed yet.  That’d be absurd.  No one does that.  The treatment for cancer is different than the treatment for diabetes, you have to diagnose a pathology first, to know what the treatment plan is.  Right, Karen?

Of course. That would be absurd. Right, Karen.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

 

 

What makes you think we have time?

I have a client.  A targeted parent father.  He so very much loved his daughter.  She’s nine.  Her mother created all sorts of barriers to the father’s love for his daughter.  Most recently was an effort by the mother to replace the father with her new boyfriend.

The father was set to actively fight for his love in court.  That’s why he contacted me, he wanted my help.  He has a very strong case. 

But then he had a massive stroke that left him paralyzed, conscious but not able to communicate.  It’s severe.  He’ll wind up dying eventually from this stroke and its aftermath, maybe six months, maybe a couple of years, but he’s not going to recover language or the ability to move.

What makes you think we have time?

My heart breaks for his daughter, the love of this dad’s life.  She will never know ever again, the kind words of love from her father, her father’s warm embrace.  Because the mental health people thought there was time, “She’s not ready” to be loved they said.  She needed time, they said.  There is no time.  Don’t they understand how this life thing works, time slips through our fingers, sand flowing away even as we try to hold onto the passing moments.

She had no time, and what little time that little girl had with her father was stolen from her by her mother’s pathology and the therapists’ ignorance.  Now, she will never be able to fix things with her father – ever.  She was robbed of that opportunity by the mental health people and their ignorance.

What makes them think we have time?  We don’t.

What really grieves me is the thought of this little girl at 18 and 25 and 35, for the rest of her life.  Her final memories of her beloved father will be of her cruelty and rejection toward him.  She’ll never have the chance to fix that.  She was robbed of that chance by the ignorance and incompetence of the mental health people who said we had time.  They were wrong. 

We have no time, only now.  We need to fix things now.  The father-daughter bond is too special.  A son’s bond to his mother, or a father and son, or a daughter’s bond to her mother, these are all too important to risk.  We need to fix them, restore love, now.  Not tomorrow, not some imaginary time when things are “ready” – ready to be loved?  How absurd.  Being loved, receiving the love of mom or dad is always a good thing.  Today, yesterday, now, whenever.  A child receiving a father’s love, a mother’s love, is always a good thing.

And we don’t have time.  Don’t you understand how this life thing works?  Children are only children once, and they have only one mother, and only one father.  The love of a father, the love of a mother is too important.  There is no time.  We need to fix things now.

We don’t have time to restore the parent-child bond.  What makes you think that the targeted parent won’t develop cancer, or have a stroke, or die in a car accident… tomorrow.  And then the child never has an opportunity for her father’s love – ever.

And her last memory of her beloved father will be of her cruelty and rejection of him.  A memory for the rest of her life.  Why did they do this to her? The mental health people.  Why did the mental health people do this to her, prevent her from loving her father and receiving her father’s love.  Now, she has lost the chance.  Forever.

It breaks my heart.  And makes me so furious at the ignorance and incompetence in forensic psychology that creates such widespread suffering, grief, and immense tragedy.   The mental health people that prevented this little girl’s bonding with her father are despicable for their ignorance and incompetence, and for what they did to this 9 year-old little girl, robbing her of her father’s love, and burdening her with a tragic final memory of her cruelty and rejection.

Understanding

We die.  We leave, so that our children can have their turn.

I’ll be leaving at some point.  Of course I will, you didn’t realize that?  You did, but you’re in denial just like those mental health people and the little girl.  They thought they had time.  A fixed and false belief that is maintained despite contrary evidence – a delusion.

It’s the way we cope with our fear and anxiety about our fragility, and our tremendous grief if we ever allowed ourselves to recognize how time will take from us all that we love and everything we hold dear.  Of course it will.  Didn’t you realize that?  Nobody is getting out of this alive.  And I wouldn’t want it any other way.  A world without children would be a terrible place to live.  Our children merit their turn on the rides, their turn at courage and struggle, victory and failure, and love.

I’ve had my 20s and my 30s.  It’s our children’s turn.

I’ll be leaving at some point.  I’ve already had two strokey things, I’m 64 and I never have taken very good care of myself – I’ve had my 20s and my 30s and my 40s, I’m okay.  And reality is real, time moves inexorably forward, for us all.

At 64, I figure I only have one more round of active work in me, if that.  By the time I’m 70 I’m going to be pretty toasty and ready to watch sunsets on my front porch with my whiskey and cigar.  You’re on your own.  And seeing the generation that’s arriving, they’re magnificent.  Your turn.

I’ll be headed over to Barcelona and the Pyrenees in September to scout possibly nesting for my final days in the Spanish Pyrenees.  My next phase is to write books.  I have four or five or six books in me.  There’s two more in the AB-PA series, Foundations was the first, but there’s still Diagnosis, and Treatment to come.  For the last two, Diagnosis and Treatment, I’m just waiting to pull the trigger on those because the time wasn’t right.  No point talking to people who aren’t listening.  I’ll wait til people are listening.

Then I’ll have another four or five books after that.  Writing in the Spanish Pyrenees with a home city of Barcelona… things could be worse.

But that means I’ll only be actively around for a bit more here.  If you want to make use of me, I’m here.  Otherwise, I’m headed off to write and watch sunsets. 

What makes you think we have time?  We don’t.

Understanding

That little girl misses her father.  She’s lost him.  Forever.  Because the ignorant mental health people thought they had time.  They didn’t.  They were just ignorant, and because of that, she’s going to suffer for the rest of her life.  Without escape.  They took that from her.

What makes you think we have time?  We need to fix things now.  Today.  Immediately.  Love is always a good thing for a child to receive.  Especially today.

Craig Childress, Psy.D.
Clinical Psychologist

 

 

Someone check on Karen, make sure she’s doing okay.

I’m worried about Karen Woodall’s psychological state, but I’m in Los Angeles.  Can someone over in England please check on her to make sure she’s okay.

Whenever I sign into my blog I get a newsfeed panel, and her blog has been showing up in this panel recently.  I typically don’t read them.  They’re just her own stuff without any scientific support.  She’s just making stuff up.  And as long as she’s basing her work on Gardnerian PAS, she’s pretty much irrelevant to any solution.  Gardnerian PAS prevents the solution.

But recently I’ve been attending to her, because we’re shifting into solutions that are grounded in actual knowledge, and as we do that the Gardnerians, particularly Karen, are seeking to sow confusion, co-opting terms and constructs that don’t apply to the PAS model, but then using them as a way of sowing confusion.  They want to pretend that there’s no such thing as AB-PA and Dr. Childress – a fantasy world where I don’t exist, so they can simply take all “my ideas” as their own.

Stupid pathogen.  They’re not my ideas.  Bowlby, Minuchin, Beck.  But I guess if you don’t know Bowlby, Minuchin, and Beck, it might sound like their my ideas.  None of this is Dr. Childress.

For the narcissistic personality – “Truth and realty are whatever I asset them to be… “I’ve always said…”  No, you haven’t. 

So I’m having to attend to the obstructionism of Karen Woodall, and Bill Benet, and the Parental Alienation Study Group (PASG).  The PASG is essentially inert.  It’s an organization created by Bill Bernet with the goal of studying “parental alienation,” as if after 40 years as a construct it needs more “study.”

Notice the difference between Bill Bernet and Dr. Childress, he forms a group to “study” “parental alienation,” I form a group to solve it.  We don’t need to study it… we need to solve it.  Different foundational attitudes.

Bill and I were in Venice last year presenting at a small conference.  I invited him and his wife to dinner, along with my wife, Peter Knudsen who had arranged my presentation in Venice, and Dorcy, who had joined me over there for the talk and for the meeting with Dr. Bernet.  We all met for dinner at the hotel.

I tried to convince Dr. Bernet to join us and collaborate on developing solutions.  I offered to write two joint articles together, one on the history and future of “parental alienation.”  In the first half of the article, Bill could describe the history of the struggle to solve “parental alienation” over the years.  Then for the second half I could talk about future directions.

We could then write a second joint article on the DSM-5 diagnosis of “parental alienation,” with a proposal for an actual full diagnosis – not simply a mention – a full diagnosis in the DSM-5 for this pathology – in the Trauma Disorders section of the DSM-5 – with – get this – the SAME diagnostic criteria as Shared Psychotic Disorder from the DSM-IV.  We’d bring back an already existing diagnosis in the DSM-IV (Shared Psychotic Disorder) and simply move it over to the Trauma Disorders section – the trans-generational transmission of trauma.  I’ll talk more about this proposal when I get around to writing the second book in the trilogy – Foundations – Diagnosis – Treatment.

But Bill refused to work together.  He insisted that I had to accept that there is a new form of pathology unique in mental health.  It’s not true.  There is no new form of pathology, the pathology is all entirely explainable using standard and established constructs and principles.

I must admit, I became frustrated at that point, and expressed my frustration to Bill, about all the children who would be lost, who would be sacrificed to this pathology because he was refusing to work together toward a solution.  It breaks my heart each family, and each day without a solution is one day too long.   And here Bill is being obstructionist, not because he thinks it will lead to a solution… he knows he has no solution… it’s because he wants to hold on to his beloved Gardner and the PAS model.  And for that, he’s willing to sacrifice tens of thousands of children to the pathology – ONLY Gardnerian PAS is allowed to solve the pathology.

On something this important, that type of obstructionism is frustrating, and heartbreaking.

I suspect the reason these “experts” have become obstructionists instead of allies is that these “experts” are not really experts in anything.  Once they lose this “new pathology” idea that they’re so fond of, they become ordinary.  They don’t like being ordinary.  I wonder why?

They’re special.  They’re “experts” and everyone needs to listen to them, because they’re discovering this whole new form of pathology.  They’re not.  They’re just atrocious diagnosticians.

At one point I tried to get Bill to activate the PASG into an advocacy organization.  Imagine if the PASG were putting pressure on the APA and forensic psychology.  Bill said no.  He said that the PASG is a “Study” group, not an advocacy group.  Its mission was to study “parental alienation,” not advocate for any changes to anything.  PASG membership… did you know that?  That your mission isn’t really to solve or change anything… it’s just to “study” the pathology – I guess at all those conferences you all like to get together at… to “study” the pathology.

Mind you, “study” refers to them all sitting around a table at their conferences and talking about it to each other, and this PAS “parental alienation” idea-thing has been around for 40 years, so they’ve pretty much talked themselves out.  Unless someone like Karen starts to decompensate and begins “discovering” new things – things she didn’t discover for the past 40 years but is now miraculously “discovering” – some sort of boost in her mental capacity I suppose.

So PASG is inert.  It will not do anything to advocate for change.  Bill won’t let them.  And he refuses to collaborate unless I accept that PAS is a real form of new pathology – which it isn’t… that’s a poison pill to our collaboration.  I could find ways around our disagreement if we wrote a joint article (we wouldn’t look too close at our differences).  But I will not wander into a false reality because Bill finds it warm and comforting.

We are solving this attachment-related family conflict pathology by returning to the established knowledge of professional psychology, Bowlby, Minuchin, Beck.

Karen Woodall is the most active obstructionist.  This is because she has her personal finances at stake.  She’s put all of her professional status into her Separation Clinic and drives the clinic’s marketing (her making money) by her being an “expert” in this new form of pathology.  Apparently her husband, Nick, is in on this too, so it’s a whole family affair.  If we return to the established knowledge of professional psychology – she’s no longer an expert and there goes all her marketing of herself and her clinic – and if we actually solve the pathology – there goes her entire clinic.  Her entire world is built on her being an “expert” in a “new form” of pathology.

Neither one is true.

So she’s been the most active in scrambling to remain relevant by obstructing and creating confusion.  To do this, she picks up on words or phrases I’m using and then mimics them, – but without meaning.  She doesn’t really understand actual psychology – so she uses the terms but then kind of twists and distorts them into what she wants them to be.  Sort of a, “Truth and reality are what I assert them to be” relationship with actual reality.

But recently I’ve been seeing a series of pictures come across my newsfeed for Karen’s Blog, and it has me worried.  I’m a clinical psychologist.  We look at multiple layers of stuff… like the possible symbolic meaning in the choices Karen is making for her pictures.  I know, she thinks the pictures relate to her blog article… but both the blog article AND the pictures are also – also – reflections of her.  It’s called projection.  All of us do it all the time.

Even me, even now.  I’ve got projective material wrapped up in this blog.  Because it’s impossible not to.  We all live in a brain, this brain has patterns, these patterns get imprinted on EVERYTHING we do.  That’s the whole principle of Gestalt therapy.  Gestalt therapy picks anything we do and then unravels it into everything we are.  It’s really powerful.

So I have my projective nonsense wrapped up in everything I do as well… it’s just that I’m a clinical psychologist, so I remove a lot of my personal nonsense beforehand, maybe 10%, and then I hide as much of my personal material as possible from public display, maybe another 10%, and then the rest is unconscious and it just goes spilling out into whatever I’m doing.  I don’t have huge nonsense, so it tends to be transparent.

Karen, though, doesn’t seem to be as sophisticated at not displaying her personal material.  Because I’m a clinical psychologist (I trained as a Gestalt therapist in my younger days), I see a lot of it.  She doesn’t realize she’s doing this, because she’s not very sophisticated, so her projective stuff is just all over the place.  That’s one of several reasons I don’t read her stuff, it feels a little intrusive into her privacy, I see deeper than I think she’d like me to see, so I just don’t pay attention.  Besides, as long as she’s holding onto Gardnerian PAS, she’s making herself entirely irrelevant.  

But recently it’s gotten concerning.  It’s the pictures.

Recently she started a descent into self-exposure with a gateway picture, the Fairy Tales picture.  I commonly refer to her Slide1stuff as unicorns and mermaids – make believe fairy tales.  So she’s announcing that shes going to enter her world of Fairy Tale beliefs.  Interestingly, she adds this picture to another different title for her actual blog – something about this “splitting” kick she’s on.  So this Fairy Tale addition is just that… an addition.  That’s always significant, when something sticks out like that.  There was no need for this… why did she add it… because it’s her material.

So this Fairy Tales signpost signals that we’re on a descent into her own material here, she is going to display her stuff.  Please don’t, Karen.  Too late.

The next picture shows the descent.  It’s a puzzle and all the pieces are put together, the Slide2pieces of her psychological makeup are all organized… except there’s big missing holes.   She presents as all put together, but if you know where to look, somethings missing, something’s not right.  What do those missing pieces represent?  Well, guess what, in this psychological process, that’s coming next.  We’re going to drop into those missing pieces next.

The next picture will show us the missing pieces, so imagine we’re going to enter one of those missing pieces, to see what’s underneath the puzzle.

The next one is not unexpected, but it is concerning.  Her actual psychological state is Slide3fractured.  So while she gives the outward appearance of all the puzzle pieces put together, except for missing places, when we penetrate her surface presentation we find that the structure is an illusion and that the entire picture, her entire psychological state, is fractured.  That shouldn’t be – especially for a mental health person.  Our inner psychological state should NOT be this.

But now she’s entered too deeply.  Beneath the cracked glass is a chaotic abyss, the glass is fragile, the glass will break, she has to return to the structured world of reality, to recompensate from her descent.

So the next picture returns to the world of everyday, announcing upcoming conferences Slide4of her being an “expert” – she is recompensating her ego, she got too close to her material and the glass threatened to break beneath her.  So she came out and re-asserted – “I’m an expert.”  Notice how this picture isn’t of the same type as the others, it’s a flyer, the others were graphics.  She has to get far away from the fractured inner material she came close to.  All the way back out, to an anchored world.

But then… the graphics are again, disturbing.  A frayed rope, almost at its breaking point.  So even while recompensating, she continues to express her troubling deeper material.  I’m worried.  If this is projective material she’s displaying, and it most likely is, she’s struggling.

Now Karen will have all sorts of real-world “explanations” for her choices in pictures.  In clinical psychology, we understand that we all have a lot of choices – about everything… but we only choose one.  Why that one?

Oh… okay.  Whatever you say.

But are you familiar with the unconscious, and how that guides our actions?

So with her recompensation, as tentative as that is, we have nearly completed our journey.  Karen has bounced down to her material, it threatened to lead her into her chaos, her fracturing of structure, so she had to pop out and restructure – a return to the real world – the outside world -with the assertion of her inflated ego-structure, “I’m an expert – everybody needs to listen to me.”  The only thing left is the consolidation of the journey.  The next image she selects will be her integration of the psychological journey into her inner material that she just went on.

Uh-oh.  That’s not good.Slide5

I’m reminded of the dead at Pompeii.  That… is a disturbing image, and if that represents Karen’s normal-consolidated integrated state, that’s not good.

Karen’s world is collapsing, and she can’t find a way to stop it.  Her stable world of Gardnerian PAS and no solution is changing.   There will be no Gardnerian PAS anymore, and she’s not going to be an “expert” anymore.  She has an over-inflated ego of unjustified self-importance, that is collapsing.

Uh-oh.  Would someone go check on Karen, make sure she’s doing okay.  I know she’s trying to make all these positive and optimistic statements – but she’s in denial.  AB-PA exists, Dr. Childress exists, and she’s in denial about that.

Her denial will save her structure for the time being.  But not for long.  No one is ever going back to Gardnerian PAS.  That ship has sailed, in fact that ship has sunk.  Titanic at the bottom of the ocean.  We’re going to switch to jet airplanes, much more efficient.

Oh, I’m sure Karen will deny that she’s in any trouble psychologically.  But still… I’m a clinical psychologist, I’m worried about her.  From where I sit, I don’t think she’s holding up so well.  Would somebody just check in with her, make sure she’s doing okay.

Karen… word of advice… stop trying to be more than you are.  Once you release the psychological burden of having to be more, special, an expert – and just return to being ordinary, things will get a lot lot better.

I’m not an expert, Karen.  I’m just a clinical psychologist.  I’m a good clinical psychologist, but that’s all I am.

Being “more” creates a false-self presentation that is absolutely nasty on the inside.  For an understanding of what happens when the ego becomes over-inflated, I’d turn to Jung, Karen.  It’s not a good thing.  The unconscious will emerge to balance, and typically through the Shadow.  That’s that picture, the last one.  That’s the shadow emerging.

For integration, all the air has to be let out of the ego, pffffffffffffffffffffftttt.  It feels really empty at first.  But this becomes the “fertile void” – that’s a Fritz Perls construct, I really love it… the fertile void for growth of self-authenticity.  Just do your job.  There’s a kid in front of you, there’s a parent… make contact… stay focused…. bring empathy, genuineness, and unconditional positive regard and fix things – simple, with that one child, with that one parent.  That’s enough, it’s always enough.

That’s way enough for me.  I don’t want to be an “expert” – pfft.  I’m just a clinical psychologist.  I just want to fix that one kid, that one parent who is sitting in front of me.  But I can’t, because the systems are broken.  So… I guess I have to fix the systems so I can fix my kiddo… but the only reason I’m fixing systems… is because of that one child, that one parent.

The world is changing, Karen.  I’m not an enemy, I’m not someone to fight against and “stop”… I’m simply being a clinical psychologist, doing what I do.  I have a kid that needs fixing – I can’t fix my kid until I fix the systems that surround my kid.  Dang.  So back in 2010 I set about fixing systems, not because I’m special… but because my kid needs the systems fixed so I can fix my kid.

I think you’ve gotten lost, Karen.  Lost from why we do this.  It’s not for us.  Its not to make us big and wonderful.  It’s for that one kid sitting across from me, that one parent in tears.  That is the entire world, Karen.  We expand out from there to do what we need to do… to fix things for that child, and that parent.

I’m not from this world of forensic psychology, Karen.  I come from obscurity, from the foster care system.  No one ever becomes famous by working in the foster care system, that’s basic county-funded work.  These are the rejected and abandoned children, our unloved children.  That’s where I was, because they need me the most over there.

Look at my vitae.  That’s not a vitae for fame and fortune.  Once I left the clinic and entered private practice, I was happily on my way to retirement and writing books about curing ADHD.  I had zero, in fact negative, interest in “high-conflict” divorce.  But I had a child.  He was 10.  He said to me, well, not in words, but he said… “Can you help me, Dr. Childress.”  I’ll see what I can do, buddy.  So he took me by the metaphorical hand and led me over here, to “high-conflict” divorce.  Oh, it’s a nightmare over here.

Since then, I’ve met so many kids, and their parents.  A lot of parents.  We need to fix this.

But I didn’t come here to be a famous “expert” – I’m here for that one kid, that one parent, who is sitting across from me.  I’ve met more of them, so many more, since being over here.  This isn’t about us, Karen.

The world is changing because it has to.  In order to fix the systems, we have to return to the established knowledge of professional psychology – all of us.  Even you.  That way, we all can come together in agreement – ALL of professional psychology, on the ground foundations of established knowledge – Bowlby, Munuchin, Beck.

And from this foundation of knowledge, we can change how the systems work in response to this pathology.  We can get proper assessments and accurate diagnoses, and most importantly, we can get effective treatments… all by returning to the established knowledge of professional psychology, Bowlby, Minuchin, Beck.

We’re ordinary, Karen.  We’re not Bowlby, we’re not Aaron Beck.  Stop trying to be more than you are.  I’m just a clinical psychologist – I’m a really good clinical psychologist, personally I think I’m the best – but I’m the best, Karen, because I know a lot of stuff, not become I have some “special” expertise personally.  I just know stuff.  I know Bowlby, and Beck, and Millon, and Tronick… and so much.  Do you know why I know so much?

Because I’m from the foster care system… I’m from our abandoned, unloved, and brutalized children.  You need to know a lot for them, don’t ya think?  With all they have going on in their world… they need the best.  No fame, no fortune.  Just work, for each child and each parent that sits across from me, they are the world.

I’m worried about you, Karen.  The world is changing, that is a fact.  As I said, I’m a really good clinical psychologist, we create change.  I’m doing that.

Think about it, Karen.  Think about releasing into the change rather than fighting to stop the change.

Ohhh, but that will mean you’ll have to give up Gardnerian PAS entirely, to return entirely to the established knowledge of professional psychology – Bowlby, Minuchin, Beck, Tronick (yeah, there’s a neuro-social piece, ya gotta understand the brain).

Let go, Karen.  Just be normal.  Holding on is fighting the ocean, and the over-inflation of ego is not going to turn out well.  Ever try to fight an ocean wave?  Not a chance.  Release into change.  But that means you won’t be an expert anymore.

But you want to know something that’s so much better than being an “expert”?  Solving this pathology for all kids everywhere, now and into the future.   We do that by changing systems, and we change systems by returning to the standard and established constructs of professional psychology – all of us.  Even you.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

 

 

 

 

 

Court-Involved Clinical Psychology and Child Custody Decision-Making

Targeted parents are human beings.  They are people.  Psychologists are not allowed to hurt people.  Anyone.  Targeted parents qualify.

Psychologists are not allowed to hurt people.  We’re not allowed to do anything that would hurt the targeted parent.

Making professional recommendations that would limit the time that targeted parents share with their children to anything less than the maximum time possible, hurts the targeted parent.  It makes them sad, very sad, it takes away from them a fundamental self-identity role of mother or father, it takes from them life experiences with their ever-growing child that can never be recaptured or recovered, the child is only five once, only ten once, only fifteen once, never again.  Lost time is lost, and this hurts the targeted parent.

Psychologists are not allowed to hurt people, not even targeted parents.  They are people.

What is the maximum amount of time?  Following divorce, that would be 50-50% shared custody visitation.  We learn about sharing in preschool.  We take turns.  It’s a fundamental principle of social cooperation.  We share.  We take turns.

Following a divorce, that would a be 50-50% shared time.  A psychologist cannot advocate for anything other than that, because anything other than that will hurt one parent or the other, will make one or the other sad, very sad, and will take from them a fundamental life role, an important experience of self-identity, their role and experience of being a mother or father.  That would hurt them.  Psychologists are not allowed to hurt people.

But sometimes situations and limitations imposed by external factors make a shared 50-50% custody visitation schedule impractical or impossible.  What do psychologists do then?  We work to limit the harm.  We don’t make decisions as to who is harmed.

This is the APA ethics code on Avoiding Harm to the client, Standard 3.04a:

3.04 Avoiding Harm
(a) Psychologists take reasonable steps to avoid harming their clients/patients, students, supervisees, research participants, organizational clients, and others with whom they work, and to minimize harm where it is foreseeable and unavoidable.

We’re not allowed to harm people, and if harm is unavoidable, we “minimize harm where it is forseeable and unavoidable.”

Sometimes the child’s need to attend a single school requires that the child has a school-week residence with one or the other parent.  This will hurt the less involved parent, it will make them sad and damage their life experience as a mother or father.  But it is unavoidable.  The child needs to be at a single school location during the school week, the child needs a single school residence.

If both parents can live close enough to each other that they can share custody visitation time with the child and the child can also have a single school, then this is the best option, then we share, we take turns, and a 50-50% shared visitation schedule is the best in “minimizing harm” caused by the divorce itself – the separation of the family structure.

But if that’s not possible, then an every-other-weekend to one parent and primary school-week custody visitation with the other parent becomes the next available option for a fair distribution of time with a minimization of the unavoidable harm to one parent or the other from divided custody time.

Giving one parent only every-other-weekend is a severe restriction on this parents time, and is less than the maximum possible.  The maximum possible would be every weekend.  If the limitation is the child’s need for a single school so that one parent is the school-week parent, then the more limited-time parent could be the weekend-parent, this would be the best outcome for the more-limited, and therefore harmed, parent.

But then the school-week parent is harmed in another way.  The school week is task oriented with homework and after-school activities, and coincides with the work-week schedule and stresses.  Weekends are a time of relaxing and quality bonding.  If we take all of these weekend times of bonding relaxation away from the school-week parent, this harms them because it harms the quality of their relationship with the child.  One parent, the weekend parent, would receive all the quality bonding time of relaxation, and the other parent would receive all the task-oriented time of schoolwork and activities.

We want to balance the quality bonding time of weekends, so we assign an every-other-weekend schedule for visitation.  But then this is less than the maximum time available for the limited-time parent, and an every-other-weekend schedule imposes a two-week absence between only brief visitation times.  We would like minimize this unavoidable harm and provide additional time to this limited-time parent if possible, to maintain a consistent presence of contact and involvement.

Because the more infrequent time parent is being harmed, and because of the long period of absence between weekend visitations, we try to add some additional consistent time for this parent.   Typically this is through additional weekday time, often a Wednesday or Thursday dinner with the child every week, sometimes for a block of time, sometimes overnight if the infrequent time parent is able to maintain the child’s single school attendance the following day.

Psychologists, however, do not decide which parent is the school-week parent and which parent is the every-other-weekend parent.  That is not our role.  Ever.  It is not the role of a psychologist to decide who is harmed, who is sacrificed.  The second clause of Standard 3.04 says we “minimize harm” – it does not direct us to decide who is harmed.  The recommendations provided above regarding shared 50-50% custody visitation time, and an alternative every-other-weekend custody visitation schedule when the harm is “unavoidable,” meets this standard to “minimize harm where it is forseeable and unavoidable.”

We do not decide on who is harmed.

But what about the greater good?   If the child would benefit from more time with one parent than the other?

Two responses.  First, psychologists do not judge people to decide who deserves to have children and who doesn’t.  That is NOT our role.  Parents have the right to parent according to their cultural values, their personal values, and their religious values.  Psychologists should NOT assume a professional role of judging which parent is the “better parent” based on criteria that cannot be supported.  If there is no child abuse, then parents have the right to be parents.  If there is child abuse and child protection factors are a consideration, then there should be a corresponding DSM-5 diagnosis of child abuse.

Psychologists should not be in a role of judging who “deserves” to be a parent and who doesn’t.

Second, the “greater good” argument for causing harm is specifically prohibited by the APA ethics code.  Standard 3.04b prohibits psychologists from consulting for or collaborating with torture practices (enhanced interrogation) of terrorists.  Even terrorists, where there is a greater-good argument about the information they possess, psychologists are not allowed to harm terrorists.  The greater-good argument for causing harm is specifically prohibited.

Psychologists are not allowed to harm people.

Targeted parents are people.  We are not allowed to harm them.

The argument made by the allied parent is that the targeted parent “deserves” to be harmed, because they are a “bad parent,” and the allied  parent wants psychology and the court to judge the targeted parent, and to punish the targeted parent because they are a “bad parent” by limiting or restricting the parent’s time with the child.

It is not the professional role of psychologists to judge people to decide if the person “deserves” to suffer and be punished for some flaw or frailty.  That is never the professional role of psychologists.  If the court wishes to take up the matter of whether one parent deserves to be punished for bad parenting, that is a legal consideration of the court.  Psychologists are never in the role of judging someone’s frailty or vulnerabilities to decide if they should be a parent, or to decide if they need to be punished for their frailty.

Psychologists do not harm people.  Targeted parents are people.

If there are frailties, we fix them.  Parents have the right to parent according to their cultural values, their personal values, and their religious values.

Everyone can recognize how we do not override cultural or religious values in parenting rights, I want to highlight personal values.  Society has no authority to override parents in their right to parent according to their personal value system.  This provides a broad latitude to parents regarding their decisions as parents.  As long as there is no child abuse (documented with a corresponding DSM-5 diagnosis of child abuse), then parents have the human right to parent according to their personal values.

Personal values are embedded in cultural values, personal values are embedded in spiritual and religious belief systems.  Personal values are respected by professional psychology.  Psychologists do not judge who is the “better parent” who “deserves” to have a larger share of time with the child, psychologists do not judge who is a “bad parent” who deserves to be less involved with the child.

If there is no child abuse, then the rights of parents to parent according to their cultural values, their personal values, and their religious values is their human right and is respected.

If there is child abuse, then this needs to be documented by a corresponding DSM-5 diagnosis of child abuse, V995.54 Child Physical Abuse, V995.53 Child Sexual Abuse, V995.52 Child Neglect, V995.51 Child Psychological Abuse.  If there is no DSM-5 diagnosis of child abuse, then there is no justification for restricting a parent’s time and involvement with their child.

Custody Visitation Schedules

The practice of child custody evaluation is a professional abomination, psychologists should never be in the role of judging parents and parceling out pain and suffering based on some ill-formed and arbitrary criteria.

Psychologists do not harm people.  Anyone.  Ever.

Targeted parents are people.  They qualify.

Child custody decision-making following divorce is not complicated.  A shared 50-50% recommendation would be the default option in all cases because it minimizes harm to each parent created by the separated family structure and need to divide visitation time with the child.  We share, we take turns.  This is a foundational principle of social cooperation taught to all of us in preschool.  It applies in adult social cooperation as well.

We share.  We take turns.

If this is not possible, and harm must be done to one or the other parent by limiting their time and involvement with their child, then an every-other-weekend (and an evening during the week) custody visitation schedule becomes the second option.

This is not complicated.  That is the recommendation of professional psychology in all cases.  Professional psychology is not in the role of judging parents and parceling out pain based on who “deserves” to suffer because they are a “bad parent” (bad spouse).

Geographic Separation

In some cases, parents are geographically separated by long distances.  In these cases, neither the 50-50% shared visitation schedule nor the every-other-weekend visitation schedule is possible.  Additional harm is unavoidable.

In geographically separated families, the child’s need for a single school location requires that one parent be designated as the school-year parent, and the other parent will receive visitation time during the child’s school vacations.  As with the every-other-weekend schedule, the limited-time parent should receive all of the vacation time to maximize their available time with the child, but then this would harm the school-year parent by taking from them all of their relaxed bonding time with the child.

Similar to weekends, holiday and vacation bonding time is typically divided equally in geographically separated families, although sometimes additional time considerations are granted to the limited-time parent during summer vacations, and a strong argument can be made in favor of this compensation summer-bump to the limited-time parent’s custody visitation time with the child.

Move Aways

When a separated family structure occurs because of the parents’ divorce, the geographic location is established and the rights of each parent-spouse are established.  No move aways are permissible except in the most exceptional of circumstances.  Each parent’s individual rights are equally valid.  To take the child away from either parent would significantly harm the limited-time parent.

Psychologists are not allowed to harm people.  Any people.  Deciding if someone should be harmed is not the professional role of psychologists.  Once the home geographic location is established, if one of the spouse-parents wants or needs to move away from that region, for whatever reason, that is their choice.  Their choice, however, should not impinge on the liberties of the other spouse-and-parent, which include the right to be an active and involved parent with their child.

Life circumstances can be difficult and can impose difficult choices.  Personal life situations and choices, however, are not the responsibility of the ex-spouse following divorce, and the rights of the ex-spouse and parent to be an active and involved parent are not made void by the wants and needs of the other spouse-and-parent.

The court may decide that special extenuating circumstances exist that warrant allowing the move away of one parent with the child.  In these circumstances, the geographically separated custody visitation schedule of a school-year parent and a vacation-primacy parent becomes the recommended custody visitation schedule.

All Children – All Families

These recommended custody visitation schedules and the sequencing of their application applies to all children and all families.

Altering these schedules for child protection factors should be accompanied by a DSM-5 diagnosis of child abuse.

Psychologists are not allowed to harm people.  Anyone.  Targeted parents are people, they qualify.  Psychologists are not allowed to do anything that harms the targeted parent…. Standard 3.04 of the APA ethics code, Avoiding Harm.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

Karen, I have a quiz for you…

DSM-5 Narcissistic Personality Disorder Criterion 1:  “Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).”



Karen Woodall, you assert that you are an “expert”… I have a quiz for you. 

You’re a mental health person, right?  So you should know symptom terms and definitions.  I have one for you.  I’ll describe the symptom and you give me the clinical term.  Ready, okay here:

The Symptom:  A fixed and false belief that is maintained despite contrary evidence.

What’s that called, Karen?

Right, a delusion.  I was pretty sure you’d get that one.  So here, let me give you a clinical application scenario and see how you do.

Say you have this person who thinks that they’re inventing something that will save the world, or that they’re making some earth-shattering new “discovery” but then it turns out that it’s not true.  It’s a false belief.  Other people have already invented the stuff or made the discoveries.  So the person’s belief that they are making great and grand new discoveries or inventing wonderful new inventions, well, it’s not true, it’s a false belief.

And then, the person is shown the contrary evidence, they are shown that someone else has already invented the things or made the discoveries, and there’s evidence that this is a false belief.  But the person ignores the evidence, the person goes into sort of fingers-in-the-ears la-la-la denial, and the person continues to insist that they are actually making these wonderful “new discoveries” that have already been discovered, despite being presented with the contrary evidence… is that a delusion?

That’s right, it is.  It is a fixed and false belief that is maintained despite contrary evidence, that’s the definition of a delusion in professional psychology.

Let me try one that’s a little harder.  If the person has a fixed and false belief, a delusion, the content of which is that they are inventing some sort of great and marvelous new invention or making some sort of historic “new discoveries,” what – TYPE – of delusion is that?  You can go ahead and think about that one for a moment.

It’s a grandiose delusion.  A false belief in being special, in being superior or above other – ordinary people – that someone has “special” talents or knowledge beyond that of other people is called a grandiose delusion.

Okay, final question, Karen… what are the main types of pathology that have grandiose delusions as a symptom feature?

Answer… ready?… there’s mania, a grandiose delusion would be considered a “mood congruent” psychotic feature of mania, and… that’s right, Karen, narcissistic personality disorder.  Delusional grandiosity is a symptom feature of narcissistic pathology.

DSM-5 Criterion 1:  “Has a grandiose sense of self-importance”

Karen, I want you to listen carefully… there is no such pathology in professional psychology called “parental alienation” – it is not a real pathology in professional psychology.  There is contrary evidence to your belief that this is a new form of pathology in professional psychology.  There is no new form of pathology, Karen.

(It’s just your ignorance showing, Karen.  You may want to tuck that away because everyone is seeing it)

Contrary Evidence 1: 

Minuchin, Bowen, and Haley all identified and fully described this pathology a full decade BEFORE Gardner proposed his new form of pathology he called “parental alienation” and in 1993 Minuchin even provided a structural family diagram for minuchin cross-genEXACTLY this pathology.  There is no “new form of pathology” – that is a false belief.

Here is the definition of a cross-generational coalition provided by Jay Haley in 1977 – a decade before Gardner and his proposal that there is a “new form of pathology” that Gardner called “parental alienation.”

From Haley:  “The people responding to each other in the triangle are not peers, but one of them is of a different generation from the other two… In the process of their interaction together, the person of one generation forms a coalition with the person of the other generation against his peer.  By ‘coalition’ is meant a process of joint action which is against the third person… The coalition between the two persons is denied.  That is, there is certain behavior which indicates a coalition which, when it is queried, will be denied as a coalition… In essence, the perverse triangle is one in which the separation of generations is breached in a covert way.  When this occurs as a repetitive pattern, the system will be pathological.” (Haley, 1977, p. 37)

Minuchin provided a clinical description of the pathology in his 1974 book, Families and Family Therapy.

From Minuchin:  “An inappropriately rigid cross-generational subsystem of mother and son versus father appears, and the boundary around this coalition of mother and son excludes the father.  A cross-generational dysfunctional transactional pattern has developed.” (p. 61-62)

From Minuchin:  “The parents were divorced six months earlier and the father is now living alone… Two of the children who were very attached to their father, now refuse any contact with him.  The younger children visit their father but express great unhappiness with the situation.” (p. 101)

From Minuchin:  “The boundary between the parental subsystem and the child becomes diffuse, and the boundary around the parents-child triad, which should be diffuse, becomes inappropriately rigid.  This type of structure is called a rigid triangle… The rigid triangle can also take the form of a stable coalition.  One of the parents joins the child in a rigidly bounded cross-generational coalition against the other parent.” (p. 102)

These are recognized expert people in families and family conflict – real ones – and Salvador Minuchin described this pathology in 1974.  Fully.  It is an established pathology in family systems therapy called a “cross-generational coalition” – you are not “discovering” anything, Karen.

A child’s rejection of a parent is called an “emotional cutoff” Karen.  It was described by the renowned family systems therapist, Murray Bowen in 1978, Karen.

From Bowen Center “The concept of emotional cutoff describes people managing their unresolved emotional issues with parents, siblings, and other family members by reducing or totally cutting off emotional contact with them.”

You are not “discovering” a new pathology, Karen.  You are simply ignorant of family systems therapy.  The pathology is fully and completely explained in family systems therapy and has been since the mid-1970s.   You are not “discovering” something, you are simply ignorant about how families work – Minuchin, Bowen, Haley, Madanes.

Contrary Evidence 2: 

In 2013, the American Psychiatric Association made a decision.  The DSM-5 Committee had fully and completely reviewed the construct of “parental alienation” as a pathology.  You, and Bill Bernet, and all the Gardnerian PAS “experts” had a full and complete opportunity to present all of your best evidence and arguments in favor of a “new form” of pathology called “parental alienation.”  What did the American Psychiatric Association say, Karen?

They said, “No” didn’t they.  The American Psychiatric Association, after reviewing all of the evidence, after you and Bill Bernet and all of your group of Garnerian PAS people had a full and complete opportunity to present all of your best arguments to the American Psychiatric Association… the APA made their judgement.   They said there is no such pathology as “parental alienation” – not a mention anywhere in the DSM-5.

If they had wanted to throw you a bone they could have included the term in their V-Code diagnosis of Child Affected By Parental Relationship Distress – a perfect spot to include the term “parental alienation” in the description.  They deliberately chose NOT to include the term, Karen.

Do you know why, Karen?  I have a YouTube series on the eight symptom features proposed by Gardner for a diagnosis of “parental alienation” – you should watch it.  Because those are all questions that you must address about your proposed “parental alienation” diagnostic model.  This is a professional critique of your work Karen:

Gardner PAS Series

The Gardnerian proposal of a “parental alienation” pathology is quite probably the WORST diagnostic model of anything ever.  It’d be up there with medieval diagnoses of “witchcraft” and “demon possession” for THE worst diagnostic models of anything ever, and “parental alienation” would likely take the top spot.  That’s why the American Psychiatric Association pointedly EXCLUDED the term “parental alienation” from the V-Code diagnosis they added, V71.29 Child Affected by Parental Relationship Distress.  They were sending you a very clear message.

They created a new V-Code, and they deliberately EXCLUDED the term “parental alienation.”  They did that to send you a very clear communication.  There is something here… but your “parental alienation” new pathology is quite probably the WORST diagnostic model of anything ever – in the history of mankind.

No, Karen, there is no “new form of pathology” called “parental alienation” – it doesn’t exist.  The American Psychiatric Association, a lot of smart people, and the DSM diagnostic committees of the top-top people in diagnosis and pathology, they had a full and complete examination of your beloved Gardnerian PAS pathology and they said… there is no such thing. 

They made their decision, the “new pathology” of “parental alienation” doesn’t exist, you’ll will have to describe the pathology using standard and established constructs and principles.  That’s what the American Psychiatric Association told you, Karen.  Back in 2013.

Those are TWO pieces of contrary information, Karen.  The first is that the pathology is already – already – fully and entirely explained within family systems therapy, and has been fully explained since the mid-1970s.  There is no “new pathology” Karen – you are simply ignorant of family systems therapy and how families function.

And two, the American Psychiatric Association’s select DSM diagnostic committees had a full and complete review of your beloved Gardnerian “parental alienation” diagnostic model, and they quite clearly and quite pointedly, said… “No.”  There is no “new pathology” called “parental alienation” – that is the clear diagnostic decision made by the American Psychiatric Association after a full and complete review of your beloved pathology proposal.  They said no.

And all you were asking for was just a mention, somewhere, anywhere in the DSM-5. You weren’t even seeking a diagnostic category, you just wanted them to use the term “parental alienation” somewhere, anywhere, in the DSM-5. They said, “No” – there is no such pathology as “parental alienation.” 

They created a V-Code for specifically this pathology – Child Affected by Parental Relationship Distress – AND they deliberately and pointedly did NOT include the term “parental alienation” in their description of this V-Code.  They could have dropped the term “parental alienation” directly into that V-Code description – and they deliberately chose NOT to.

You, and Bernet, and Miller, and Baker, all of you “parental alienation” people have received a clear communication from the DSM diagnostic committees of the American Psychiatric Association – there is no “new pathology” of “parental alienation.”  I live in reality, Karen.  The APA reviewed the evidence and made a decision.  It was the correct decision.  The diagnostic model you propose for a “new pathology” of “parental alienation” is probably the WORST diagnostic model in all of history.  That’s why the APA pointedly said, “No.”

You have two – irrefutable – pieces of contrary evidence to your false belief that there is a “new pathology” you are “discovering” and are somehow an “expert” in, that you are an important and special “expert” in this new form of pathology – that doesn’t exist – that you are simply making up.

But despite clear contrary evidence, you still believe that there is a “new form of pathology” that you’re “discovering,” don’t you Karen?  You still believe you’re making these special discoveries about this new pathology, and you still believe that you’re somehow this special “expert” in this new form of pathology… that actually doesn’t exist.  But you believe it exists – even though it doesn’t.

A fixed and false belief, Karen, that is maintained despite contrary evidence.  What’s that called again?  That’s right, a delusion.  A fixed and false belief that is maintained despite contrary evidence… that’s the definition of a delusion, Karen.  Not my definition, the clinical definition in professional psychology for a delusion.

And if the person has a delusion about being “special” – about being important and in a position of elevated status – like being a special “expert” in something – and believing that because of their “special” status that everyone should pay attention to what this person says, because the person believes they are making important “discoveries” – but none of it is true – that would be a classified as grandiose delusion, wouldn’t it Karen.  You’re a mental health person, you know how diagnosis works.

A fixed and false belief that is maintained despite contrary evidence that the person is somehow “special” – a special “expert” making grand “new discoveries” – that aren’t true… that would be a grandiose delusion. 

Final Question, Karen

Let me ask you one last thing, Karen, and remember, I’m a clinical psychologist. 

Two questions, actually.  First, is there a new form of pathology, this “parental alienation” thing you’re proposing, is that a real form of pathology?  

Second, do you believe that you are making special and important “discoveries” about this supposedly new form of pathology?

And, as long as I’m here, let me ask a final, third, question… do you believe that you have “special” knowledge about this pathology that other people, us ordinary people, don’t have?  Do you believe that you are a special “expert” Karen?

Your answers are – yes – yes – yes – aren’t they, Karen.  You know they are, I know they are, we all know you answered yes, yes, yes. 

Do you think this “new form of pathology” exists? – yes. 

Do you believe you are making important “new discoveries” about his supposedly new form of pathology? – yes.

And do you believe that you have “special knowledge” about this supposedly “new form of pathology” that you’re discovering that makes you an “expert” – someone important – who people should listen to, because you’re important? – yes.

Karen… you appear to be delusional.  It’s called a grandiose delusion. Now I’m not diagnosing you, Karen, because I have not personally conducted a clinical interview with you… but I’m just sayin’ – looks like a duck quacks like a duck.

Seriously.  A fixed and false belief that is maintained despite contrary evidence is the clinical definition of a delusion, and the contrary evidence to your belief in a “new form of pathology” that you are supposedly “discovering” is that Minchin, Haley, and Bowen a full decade BEFORE Gardner, fully and completely described the pathology – cross-generational coalition, emotional cutoff, multi-generational trauma – AND – AND – that the American Psychiatric Association said, after a full and complete review of your beloved “parental alienation” new pathology proposal, that there is no such pathology of “parental alienation” – contrary evidence, Karen.  The APA told you, it is a false belief.  That is contrary evidence to your belief, the American Psychiatric Association told you, “It is a false belief.”

If THAT is not evidence to convince you, Karen, the American Psychiatric Association directly rebuking the construct of a “new form of pathology” – what evidence would you need?  Seriously, Karen… there is no evidence EVER that would ever convince you, is there Karen?  Because it’s a delusion.  It’s a fixed and false belief that is maintained DESPITE contrary evidence.  That’s the definition.  There is no way to alter a delusional belief with evidence – evidence is completely ignored – that is the definition of a delusion – despite contrary evidence.

Tell us, Karen, what evidence WOULD convince you that there is no “new pathology” and that this thing you’re calling “parental alienation” is entirely describable using the already existing and already established constructs and principles of professional psychology? 

Bonus Points

One final question, Karen, for bonus points.  You’re a mental health person, but still, I’m not sure how much you know about psychotic disorders, so this might be a toughie for you… what is it called when two or more people share the same delusional belief?  

That’s right, it’s called a shared delusional disorder (ICD-10: F24).

So let’s see, you’re an “expert” in this “new pathology”- anyone else?  Bill Bernet, okay.  Anyone else believe that there is a “new form of pathology” and that they are a “special” expert with “special knowledge” about this “new form of pathology” they’re creating?  Anyone else have this fixed and false belief that and they are making important new “discoveries”?

Wait… you may have an out, Karen.  There is an escape clause to delusions if it is a shared belief system – it’s called a sub-cultural exception.  It’s like when a bunch of people go to the wilderness and build a compound because they all believe space alien angels are going to lift them to heaven in rapture on a certain date, and then that date passes, but they just change the date.  Them.  We may not call them “delusional” and instead we call it a “sub-culture” belief.  That’s the technical term.  The more common term is a cult.

So diagnostically, Karen, we appear to be looking at either a shared delusional belief system or you’re part of a cult if you claim the sub-culture exemption from a delusional diagnosis.  Did you know all this about diagnosis, Karen?  Do you realize that, diagnostically you are showing all the symptom features of a grandiose delusion, and that you appear to potentially be part of a cult – a “sub-cultural” exception to a shared delusional diagnosis.

Although, I might still go with the shared delusional diagnosis for you all.  It would depend on the clinical interviews.  You’re all mental health people, you’re not supposed to be part of a cult, you’re supposed to be living in reality with the rest of us, so I’m not sure I’d allow the sub-cultural cult exception for a delusional diagnosis.

Reality Karen

There is no “new pathology,” Karen.  You are simply ignorant of family systems therapy.  You are not a special “expert” in any “new pathology,” Karen.  You are simply grandiose.  It’s called an encapsulated grandiose delusion, if you don’t have manic symptom in your history, I’d think about the potential for narcissistic pathology.  I’m not diagnosing you, Karen.  I haven’t interviewed you.  I’m just saying, that’s what I’m seeing.

DSM-5 Narcissistic Personality Disorder Criterion 1:  “Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).”

You know what would be interesting, Karen?  To take a look at your vitae relative your your claims of achievements and talents – your being an “expert” – to see if they are exaggerated claims of achievements and talents – if you have a desire “to be recognized as superior” – as an “expert”… “without commensurate achievements.”  

Where did you receive your training in attachment pathology, Karen?  Where did you receive your training in family systems therapy, Karen?  And yet, you are claiming to be a special “expert” in attachment pathology occurring in the context of family conflict… “recognized as superior without commensurate achievements”… you have no training in either attachment pathology or family systems therapy.

It’d be interesting to see your vitae, Karen.  To see if substance matches assertion.

Oh, Karen… and just to give you a reference for what an expert looks like, this is the professional background description for Keith Nuechterlein.  I worked with Keith at UCLA for over a decade, you’ll see it listed on my vitae, the Aftercare Clinic.  Keith attended my wedding in Yosemite. 

Keith Nuechterlein is an expert in schizophrenia.  This is what an expert vitae background looks like.  Notice he has authored over 235 journal articles – and none of them are “opinion pieces” they are all NIMH major-journal research articles – over 235 of them.  When we’d sent his vitae to NIMH as part of grant submissions, it’d be 25 pages long of major journal research studies.  This is what an expert in professional psychology looks like, Karen.

This is the standard you need to meet to be considered an “expert” Karen, in the real world of actual reality.

Keith Nuechterlein:  A Real Expert, Karen

From Nuechterlein UCLA Profile:  The Center is led by Keith H. Nuechterlein, Ph.D., Professor of Psychology at the University of California, Los Angeles, and Director of the Aftercare Program, a research clinic for schizophrenic patients, UCLA Semel Institute of Neuroscience and Human Behavior. Dr. Nuechterlein specializes in neurocognitive processes in schizophrenia, especially as they relate to both the developmental course of the disorder and to functional outcome. Dr. Nuechterlein’s ongoing longitudinal study of the early course of schizophrenia, “Developmental Processes in Schizophrenic Disorders”, has closely examined the influence of specific neurocognitive vulnerability indicators on the early course of first-episode patients, with an emphasis on occupational and educational outcome. He holds a joint appointment in the Department of Psychiatry and Biobehavioral Sciences and the Department of Psychology (Clinical and Behavioral Neuroscience areas) at UCLA.

From UCLA Profile:  Keith H. Nuechterlein, Ph.D., is a Professor in the Departments of Psychiatry and Biobehavioral Sciences and of Psychology at the University of California, Los Angeles. He serves as the Director of the UCLA Center for Neurocognition and Emotion in Schizophrenia, an NIMH-funded Translational Research Center in Behavioral Science.  He also is the Director of the UCLA Aftercare Research Program, a research clinic devoted to research and treatment with patients who have had a recent onset of schizophrenia.  Dr. Nuechterlein received his B.A. in psychology in 1970 and his Ph.D. in Psychology (Clinical) in 1978 from the University of Minnesota.  His expertise focuses on cognitive deficits in schizophrenia, their role as genetic vulnerability factors, their connections to functional outcome, and their remediation.  Dr. Nuechterlein has authored more than 235 journal articles and is among the scientists on the ISI Web of Knowledge Highly Cited list for Psychology/Psychiatry. He has been on the editorial boards of the Journal of Abnormal Psychology and Schizophrenia Bulletin and is currently on the editorial board of Psychological Medicine. He has received numerous research grants from NIMH and other sources. Dr. Nuechterlein served as the Co-Chair of the Neurocognition Committee for the NIMH-funded initiative, Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS). This group guided the development of the MATRICS Consensus Cognitive Battery, a standardized outcome measure for clinical trials to assess the impact of new interventions on core cognitive deficits in schizophrenia. Dr. Nuechterlein is a past-president of the Society for Research in Psychopathology.

Jim Swanson: A Real Expert, Karen

picture of James M. Swanson

I worked with Dr. Swanson at UCI when I was with Childrens’ Hospital of Orange County.  I was recruited by Choc specifically to work as the lead clinical psychologist on Dr. Swanson’s project for ADHD in preschool-age children. 

This is what an expert in pathology looks like, Karen.  In reality.  In the real world where I come from.  His research list on the website is just a smattering, his research vitae is also 25 pages long.  He was one of the principle investigator sites for the big MTA study of ADHD back in the 90s, and almost all of the school-based research on ADHD comes from his lab, the UCI Child Development Center.  He is the UCI Child Development Center. 

This is what an expert looks like, Karen.  Notice he’s a PhD psychologist yet sits as a full professor at the UCI School of Medicine.

From Swanson UCI Profile

Director, Child Development Center, Pediatrics
School of Medicine
Professor, Pediatrics
School of Medicine
Professor, Epidemiology
School of Medicine
PH.D., Ohio State University

Research Interests
ADD, ADHD, Child Development

Research Abstract

Dr. Swanson’s research focuses on hyperactivity, attention deficit disorder and conduct disorder in children. Through his research, Dr. Swanson has developed procedures for monitoring the cognitive effect of stimulant medication, the most frequent treatment for this group of patients. His research also focuses on biochemical and genetic factors related to these disorders

Dr. Swanson is also investigating the effect of intensive, early intervention for children with attention and conduct disorders through a school-based treatment program conducted in cooperation with the Orange County Department of Education. This program is carried out at the Child Development Center. In addition, he is evaluating the risk and protective factors for anti-social behavior of hyperactive children as they mature.

Publications

Swanson JM, Kraemer HC, Hinshaw, SP, Arnold, LE, Conners, CK, Abikoff, HB, Clevenger W, Davies M, Elliott, G, Greenhill, LL, Hechtman, L, Hoza, B, Jensen, PS, March, JS, Newcorn JH, Owens L, Pelham, WE, Schiller E, Severe, J, Simpson S, Vitiello, B, Wells, CK, Wigal, T, Wu, M. (2001). Clinical Relevance of the Primary Findings of the MTA: Success Rates Based on Severity of ADHD and ODD Symptoms at the End of Treatment. J. Amer. Acad. Child & Adolesc. Psychiatry, 40(2): 168-179.

Swanson JM, Posner M, Wasdell M, Sommer T, Fan J. (2001). Genes and Attention Deficit Hyperactivity Disorder. Current Psychiatry Reports, 3: 92-100.

Swanson JM, Hanley T, Simpson S, Davies M, Schulte A, Wells K, Hinshaw S, Abikoff H, Hechtman L, Pelham W, Hoza B, Severe J, Molina B, Odbert B, Forness S, Gresham F, Arnold LE, Wigal T, Wasdell M, Greenhill L. (2000). Evaluation of Learning Disorders in Children with a Psychiatric Disorder: An Example From the Multimodal Treatment Study for ADHD (MTA Study). In L.L. Greenhill (Ed.), Learning Disabilities: Implications for Psychiatric Treatment, 19(5): 97-125

Swanson JM, Volkow N. (2001). Pharmacokinetic and Pharmacodynamic Properties of Methylphenidate in Humans. In M.V. Solanto, A.F.T. Arnsten, F.X. Castellanos. (Eds.), Stimulant Drugs and ADHD: Basic and Clinical Neuroscience, (pp. 259-282). Oxford University Press.

Swanson, JM. (1992). School-based Assessments and Interventions for ADD students. Irvine, CA: K.C. Publishing.

Swanson JM, Riederer SA, Young RK. (1974). IMPS: Interactive Math Package for Statistics. Publication IM/18/8/23/74 of Project C-BE, University of Texas, Austin.

Malone MA; Kershner JR; Swanson JM. Hemispheric processing and methylphenidate effects in attention-deficit hyperactivity disorder. Journal of Child Neurology, 1994 Apr, 9(2):181-9.

Malone MA; Swanson JM. Effects of methylphenidate on impulsive responding in children with attention-deficit hyperactivity disorder. Journal of Child Neurology, 1993 Apr, 8(2):157-63.

Craft S; Gourovitch ML; Dowton SB; Swanson JM; Bonforte S. Lateralized deficits in visual attention in males with developmental dopamine depletion. Neuropsychologia, 1992 Apr, 30(4):341-51.

Forness SR; Swanson JM; Cantwell DP; Youpa D; Hanna GL. Stimulant medication and reading performance: follow-up on sustained dose in ADHD boys with and without conduct disorders. Journal of Learning Disabilities, 1992 Feb, 25(2):115-23.

Grant
National Children’s Study (NCS)

Professional Society
Senior Fellow, Sackler Institute at Cornell University

Research Center
Child Development Center



Your turn, Karen. 

You claim to be an “expert” in this attachment-related family conflict pathology.  Post your vitae, let’s have a look at the actual substance of your claimed “expertise” in attachment-related family pathology – or are you expecting to be “recognized as superior without commensurate achievements” – let’s have a look at your vitae, Karen.

You are the one who is so prominently claiming to be an “expert” – back it up, Karen, because I don’t believe you are an “expert” in anything – I suspect it’s simply a grandiose delusion.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

 

 

 

Attachment and the Psychoanalytic School of Psychology

I’m educating parents and legal professionals about professional psychology because the forensic psychology people are awful – just awful.  They have no knowledge, they apply no knowledge.  They just make things up.

They shouldn’t be doing that.  They should be applying the established knowledge of professional psychology to their assessment, diagnosis, and treatment of pathology.  They’re not.  That’s a big-big problem that currently sits unresolved with the APA,

APA: Complicity with Child Abuse

Forensic psychology is not doing their job, and in fact, is harming the consumers of their mental health services, their clients.  They are harming their clients because they are applying NONE of the knowledge from professional psychology from the past 100 years.  None of it.

Not psychoanalytic knowledge, that’s from the 1930s and 40s.  They are not applying the knowledge of cognitive-behavioral psychology (Skinner, Beck).  That’s from the 1940s to 60s.  They are not applying knowledge from family systems therapy.  That’s knowledge from the 1970s and 80s.  They’re not applying knowledge of the attachment system, that’s knowledge from the 1960s to 2000s.  They’re not applying knowledge from social constructionism and cultural psychology.  That’s knowledge from the 1980s to 2000s.  They’re not applying knowledge from psychometrics, that’s knowledge from the 1940s to 80s.  They’re not applying knowledge from complex trauma.  That’s knowledge from the 1990s and 2000s.  They are applying none of the neuro-developmental research on brain development during childhood, that’s from the 1990s to now. 

None of it.  They are applying none of it, none of the knowledge from the past 100 years in professional psychology.  None of it.

And their absence of knowing the knowledge of professional psychology, and their absence of applying the knowledge of professional psychology, is harming parents and their children.  The absence of knowledge is a violation of Standard 2.01a of the APA ethics code, the failure to apply knowledge is a violation of Standard 2.04 of the APA ethics code.

In order to protect the consumers of mental health services from the abject ignorance of forensic psychology and their failure to apply any knowledge from professional psychology to their assessment, diagnosis, and treatment of pathology, the parents who are seeking to protect themselves from IPV (Intimate Partner Violence) emotional spousal abuse and their children from Child Psychological Abuse will need to become more knowledgeable than their therapists about the established constructs and principles of professional psychology.

That’s not good.  That consumers of mental health services should need to know more than the mental health professional about pathology and its treatment should NEVER happen.  It is, however, the current reality.  So we have to deal with that.

Consumers of psychological services – you, the parents – will have to become more knowledgeable about professional psychology than your therapist is.  Family law attorneys who are assisting their clients achieve a solution through the courts will need to become more knowledgeable about professional psychology than the therapists are.

Ultimately, when professional psychology begins to apply knowledge to solve pathology, then the knowledgeable family law attorney, the knowledge court, and the knowledgeable mental health professional can effectively and efficiently guide the family conflict into solution.

Ignorance will create no solution.  It is only through the application of professional knowledge to the diagnosis and treatment of family pathology that we will create a solution.

But we’re not there yet.  Right now, the field of forensic psychology is applying NO knowledge from professional psychology in their assessments, diagnoses, and treatment.  They are simply making things up.  In this environment of gross professional negligence and incompetence, our first task is to protect parents and children from the emotional and psychological abuse emanating from the more emotionally fragile and pathogenic allied parent who is weaponizing the child into the spousal conflict.

I’m a clinical psychologist.  During this period right now, in which the goal is to stop the active ongoing emotional abuse and traumatization of parents and the psychological abuse of their children, part of my role as a clinical psychologist is to educate the public about matters of professional psychology, and the knowledge of professional psychology. 

For example, when I conduct a school-involved assessment and find a learning disability, part of my role is to educate the parents and the school about what a learning disability is, and what they can to do to help support the child’s healthy development.  Part of our role as clinical psychologists is to educate consumers and the public regarding the principles and constructs of professional psychology.

Consumers of mental health services – targeted parents and their children – are being harmed – in violation of Standard 3.04a of the APA ethics code – by the professionally negligent and irresponsible ignorance from their mental health provider, who is failing to apply any of the established knowledge from professional psychology to the assessment, diagnosis, and treatment of pathology in violation of Standards 2.04 and 2.01a of the APA ethics code.

As a clinical psychologist, it is incumbent upon my professional responsibilities to educate and empower the public, the consumers of mental health services who are being harmed by the ignorance and incompetence of their mental health care provider, regarding the professional knowledge that is NOT being applied but should be applied, and regarding professional standards of practice that are NOT being met, but should be.

My book, Foundations, is one tool in this education effort.  Handouts on my website are another resource for parents and legal professionals.  In this blog post, I will take a more direct instruction role regarding the extent and nature of the information that is NOT being applied, but should be.  We will be using bricks to build a structure, the bricks of knowledge will come from domains of professional psychology, each brick adds another piece to the overall structure of knowledge.

We will begin by orienting to the world of psychology generally, and then start with the psychoanalytic school of professional psychology – Freud, Klein, Erikson, Adler, Jung, Mahler, Masterson, Kernberg, Winnicott, Kohut, Bowlby, Stern, Fonagy, Tronick.

Orienting to Psychoanalysis

Rely on family systems therapy for now, .

With this court-involved family conflict pathology, we will start the solution by using family systems therapy as the foundation for solutions (for right now).  Family systems therapy (Minuchin, Bowen, Haley, Madanes) will solve everything.  Family systems therapy is THE appropriate school of professional psychology to apply to the resolution of family pathology.  Family pathology = family systems therapy (Minuchin, Bowen, Haley, Madanes).  The constructs of triangles, cross-generational coalition, emotional cutoff, and multi-generational trauma all come from family systems therapy – not from the psychoanalytic school.

However, each additional domain of knowledge that we add to family systems therapy adds immensely useful knowledge that can be applied to creating the solution.  The more knowledge we apply, the more fulsome and complete becomes our solution.

The down side to applying multiple domains of professional knowledge to the solution is that when we use a wide-range of ideas, such as including knowledge about narcissistic personality pathology or the attachment system, things can begin to sound confusing and ideas become scattered all over the place.

Parents and legal professionals… remain grounded in family systems therapy.  Family systems therapy will solve everything – cross-generational coalition, emotional cutoff, multi-generational trauma.  I will be educating about additional knowledge, but the core of the solution is found in family systems therapy.  Family systems therapy is THE school of psychology to apply to solving family conflict.

The first time we hear something, it’s new.  Hear it 10 times, it becomes old and familiar. The constructs of a cross-generational coalition and emotional cutoff will become oh-so-familiar over time.  Once this ground knowledge is applied, we will then expand the domains of additional knowledge we apply for more robust, easier, and more efficient solutions in the interface of professional psychology and the family courts.

In learning, it helps to have the boxes, the knowledge structures in our brain, to put stuff in, a context to organize all the different ideas.  The best content boxes for organizing professional psychology ideas are the four primary schools of psychotherapy – psychoanalytic, humanistic-existential, cognitive-behavioral, and family systems.  Nearly everything in professional psychology fits into one of these four boxes, and all the stuff that’s in the same box shares common characteristics. 

All the ideas in humanistic-existential psychology share basic core concepts.  All the ideas in cognitive-behavioral psychology share basic core concepts.  All the ideas in family systems therapy share basic core concepts.

The four schools of psychotherapy are psychoanalytic (Freud-Bowlby), cognitive-behavioral (Skinner-Beck), humanistic-existential (Rogers-Perls), and family systems therapy (Minuchin-Bowen).  To solve this court-involved family conflict pathology, remain within family systems therapy and you will solve everything, apply additional knowledge from the other schools and achieve a more robust and fulsome solution.

The Psychoanalytic School

Attachment (Bowlby, Ainsworth) is from the psychoanalytic school.  It is important that parents and legal professional understand and orient to the psychoanalytic domain of knowledge because that’s where the attachment system knowledge and… the neuro-developmental knowledge (Stern, Tronick)… is anchored.  The psychoanalytic field of professional psychology gave birth to our understanding of the attachment system (Bowlby, Ainsworth).

Psychoanalytic psychology emerged from Sigmund Freud and the couch.  The core of the psychoanalytic school is – meaning – determining what things mean, not just what they are in their external manifestation, and the interpretation of meaning is a big-big part of the psychoanalytic school.  Because of this, psychoanalysis is also called “depth psychology” because… well, it goes deep, way deep, into the psychological organization of our minds. 

Minchin, Bowen, Haley… they are all from the family systems school, a different school of psychology, not this one.  Family systems people organize multiple people interacting together in the here-and-now.  Psychoanalytic people organize one person way-deep, looking more toward childhood than the present.  Bowlby, Stern, Siegel, and Tronick are all from the psychoanalytic world of meaning.   Discovering meaning is the central question for the psychoanalytic school.

But in going deeper into meaning, psychoanalytic psychology goes to realms that rigorous mathematical models can’t go, psychoanalytic psychology sacrifices the scientific rigor of some research methodologies for the quality of information they return.  The psychoanalytic school doesn’t do the classic type of experimental design research – those come from the cognitive-behavioral people in professional psychology.  The psychoanalytic school relies almost entirely on case study research designs, which is a formal research methodology, and information is housed in their case study reports from psychoanalysis using basic established constructs within the field.

Freud opened doors to understanding many things, and we continue to hold many of ideas that Freud developed, such as the ideas of an “unconscious” and of our “defense mechanisms.”  But a lot of Freud’s specific insights and suggestions have been revised and modified, creating different, more evolved sub-domains of psychoanalytic thought than how Freud first organized our unconscious processes.

One of the primary sub-domains that has evolved within the psychoanalytic school is called the “object relations” school.  Bowlby and attachment theory are from the object relations sub-domain of the psychoanalytic school.

The term “object” in the psychoanalytic world is their word for “people.” A technical description is: people are “internalized objects” in our “representational networks” – the representational networks are the various categories of things, dog, chair, mother, you, the things of our mind.  We have ideas for things, chairs and trees, and we have ideas for special people – mothers, fathers, grandparents, spouses.   We internalize features of these special people in our lives – and these people become internal “objects” in our mind-space of meaning.  That’s the school of object relations, looking at our internalized representations for other, special, people. 

In common-speak, the sub-domain of object relations is “people relations” – as opposed to Freud’s emphasis on instinctual animalistic “drives” for sex and violence (bonding and conflict).  The object-relations school emphasizes people’s psychological motivation to bond to each other.  Bowlby and attachment are from this school of psychology.

Adult Object Relations

There’s a lot of adult object relations psychoanalysts who looked at relationships from the adult side of things, two of the most famous are Otto Kernberg who studied narcissistic and borderline pathology and Heinz Kohut who developed a function-oriented model of our inner relationship world.  Heinz Kohut is the current major kahuna in adult psychoanalysis, and most psychoanalytic psychotherapists work from a Kohutian approach. 

Kohut proposed that parents serve specific functions (roles) for children, which he called “self-object” functions, and that these functions become internalized into the inside-the-head “representational networks” of the child.  Kohut’s identifies three “self-object” functions that parents serve for the child, and these self-object functions help organize the child’s sense of self-identity (called “self-structure”) and help to regulate the child’s emotions.  The three self-object roles are broadly, empathy, bonding, and protection; called mirroring, twinship, and idealizing.

Otto Kernberg conducted depth psychoanalysis with adult narcissistic and borderline pathology.  You do NOT conduct depth psychoanalysis on the narcissistic and borderline personality.  Their personality self-structures are too fragile for the techniques of psychoanalysis and will collapse into what’s called a “psychotic transference” – that is not good. 

In psychoanalysis, the patient becomes neurotic (slightly crazy).  The patient imposes the trauma patterns from their past onto the analyst in the present, who then interprets the patient’s trauma reenactment narrative – called “the transference” – the patient’s transfer of childhood trauma patterns onto the current analyst. 

The techniques of psychoanalysis create a neurotic transference – the activation and transfer of past trauma patterns.  The patient – the “analysand” – goes a little crazy, called a “neurosis,” but remains in contact with actual reality.  They become disoriented and confused about who the analyst actually is and their own fears and hopes for who the analyst is that were created in their childhood experiences.  The techniques of psychoanalysis create neurotic transference which is then interpreted for the analysand by the analyst, leading to insight, empowerment, choice, and change.

But the narcissistic and borderline personality structure is too fragile for the depth-psychology techniques of psychoanalysis which loosen the boundaries of self-structure. In psychoanalysis, the narcissistic and borderline personality collapses into a psychotic transference – they lose touch with reality.  That’s not good.  We don’t want to create a psychosis in the patient.  So the general guidelines in psychoanalysis are… do not do psychoanalysis with a narcissistic or borderline patient.  They do something called psychoanalytic psychotherapy – a more structured form of the psychoanalytic approach than depth-psychoanalysis (psychotherapy not psychoanalysis;  different approaches).

Otto Kernberg was an exceptionally skilled psychoanalyst.  He conducted depth psychoanalysis with the borderline and narcissistic personality.  He returned with incredibly valuable information from psychoanalytic depth psychology regarding the deep-structure of the borderline and narcissistic pathology.  That’s what makes Kernberg one of the preeminent authorities on the pathology of the borderline and narcissistic personality.  Otto Kernberg literally wrote the book on the borderline and narcissistic personality:

Kernberg, O.F. (1975). Borderline Conditions and Pathological Narcissism. New York: Aronson.

Notice the date.  This is not new information. 

Childhood Object Relations

Our object relations (our patterns for relating to other people in intimate relationships) are created in childhood.  So another group of object relations psychoanalysts in the 1950s and 60s went off to study children directly – Winnicott and Bowlby are the two primary child object relations kahunas.  John Bowlby and attachment theory is from the object relations school of psychoanalysis, the child side.

Attachment theory as developed by Bowlby would have remained largely contained within the psychoanalytic world except that Mary Ainsworth developed a way to experimentally categorize different types of attachment bonding – as either secure or insecure, with three types of insecure attachment.

The moment we can bring something into the lab for experiments at the local university, more scientifically grounded research designs become available, and science is off and running.  So that’s why you’ll hear Bowlby and Ainsworth linked in professional discussions.  Bowlby developed the underlying description of what the attachment bonding system is, Mary Ainsworth made it available for scientific study.

This is a quote from Mary Ainsworth describing what the attachment system is.  It’s from an article published in THE professional journal of the APA, American Psychologist.  This quote serves as a foundational description for what the attachment system is.

Ainsworth, M.D.S. (1989).  Attachments Beyond Infancy.  American Psychologist, 44, 709-716.

From Ainsworth: “I define an “affectional bond” as a relatively long-enduring tie in which the partner is important as a unique individual and is interchangeable with none other. In an affectional bond, there is a desire to maintain closeness to the partner. In older children and adults, that closeness may to some extent be sustained over time and distance and during absences, but nevertheless there is at least an intermittent desire to reestablish proximity and interaction, and pleasure – often joy – upon reunion. Inexplicable separation tends to cause distress, and permanent loss would cause grief.” (p. 711)

From Ainsworth: “An ”attachment” is an affectional bond, and hence an attachment figure is never wholly interchangeable with or replaceable by another, even though there may be others to whom one is also attached. In attachments, as in other affectional bonds, there is a need to maintain proximity, distress upon inexplicable separation, pleasure and joy upon reunion, and grief at loss.” (p. 711)

For court-involved family conflict, this quote from Ainsworth is the foundational bedrock we are standing on when we talk about the attachment system.  This is a description of a normal and healthy attachment system – to achieve this description for the attachment system is ALWAYS our goal in professional psychology – we never accept  less.  Anything OTHER than this description of a child’s attachment bonding motivation… is pathological. 

Mary Ainsworth’s description is of a healthy attachment system.  Achieving a health attachment system in a child is ALWAYS the goal of professional psychology.

The attachment system is a primary motivational system of the brain, analogous to the other primary motivational systems for eating and sex – they are all primary, fundamental, neurologically based motivational systems of the brain.  The attachment system is called a “goal-corrected” motivational system – meaning that it ALWAYS maintains the goal of forming an attachment bond to the parent.  Always.  A child who rejects a parent is eaten by a predator (or starves, or falls off a cliff).  Historically, throughout millions of years of evolution, children who rejected parents… died.  Children do not reject parents.

Children are motivated to seek the love of their parents – a primary motivational system of the brain.  The entire attachment system is organized around the child acquiring the love of the parent.  It’s called the attachment system.  It is extremely well researched and understood.

The attachment system functions in characteristic ways, and it dysfunctions in characteristic ways.  In response to bad parenting, the attachment system MORE strongly motivates the child to bond to the bad parent – to acquire the love of the bad parent. Children who rejected bad parents were eaten by predators.  Children who become MORE strongly motivated to bond to the bad parent had a chance of obtaining parental protection… they survived.

From Bowlby:  “The paradoxical finding that the more punishment a juvenile receives the stronger becomes its attachment to the punishing figure, very difficult to explain on any other theory, is compatible with the view that the function of attachment behavior is protection from predators.” (Bowlby, 1969, p. 227)

Notice the date, 1969, this is not new information

Bad parenting produces an “insecure attachment” – there are three types – three categories – of insecure attachment, high-protest, low-protest, disorganized.

Anxious-Ambivalent Attachment:  This is a high-protest display by the child of excessive anger or anxiety.  This type of child insecure attachment is caused by the inconsistent availability of the parent.  The treatment for high-protest anxious-ambivalent attachment is to increase the stability and consistency in the child’s bond to the parent, with more frequent displays of love and involvement from the parent. 

Court-Involved Family Conflict:  This is the type of insecure attachment pattern that is being mimicked – i.e., falsely portrayed – in court-involved family conflict.  In this high-litigation post-divorce family conflict, the child is presenting with high-protest emotional signaling of elevated anger and anxiety symptoms – called “high-protest signaling.” 

In authentic attachment, this high-protest signaling by the child is called an “attachment behavior” (along with other behaviors like smiling  and following) and is designed to ELICIT the greater involvement of the inconsistently available parent.  Child protest behavior serves the attachment function of eliciting greater parental involvement with the child.

In court-involved family conflict, this child symptom display is a false display of attachment pathology.  Instead of seeking to bond to the parent, the protest behavior seeks to sever the parent-child bond.  The attachment system NEVER seeks to sever the parent-child bond.  Children who rejected parents were eaten by predators.

In court-involved family conflict, the child’s emotional display mimics an insecure anxious-ambivalent attachment, but it is a false symptom – that is NOT how protest behavior works in an authentic child attachment system, that is NOT how the brain works.

AND… AND, the treatment for an insecure anxious-ambivalent attachment is to INCREASE the child’s time and involvement with the parent where there is protest behavior – i.e., the child should have MORE time and MORE involvement with the targeted parent – that’s the treatment for high-protest anxious-ambivalent attachment – which this isn’t but mimics.

There are multiple additional features to the child’s symptom display surrounding this court-involved family conflict that are clearly a false display representing a false, externally influenced, non-authentic conflict with the targeted parent… and even still the treatment for insecure anxious-ambivalent high-protest attachment would be to provide the child with MORE time, MORE involvement, and MORE love from the targeted parent.

The treatment for an insecure anxious-ambivalent attachment is NEVER to reduce the child’s time and involvement with the parent.  An anxious-ambivalent high-protest attachment is always caused by an INCONSISTENTLY available parent.  We want to INCREASE the availability of this parent – notNOTdecrease it.

Anxious-Avoidant Attachment:  This is a low-protest display by the child, in which the child is exceeding low-demand and overly self-sufficient, seeking limited to no emotional contact with the parent.  This type of insecure child attachment bond is caused by a parent who is emotionally overwhelmed, rejecting, and unavailable for the child.  The child learns that demands for parental involvement provoke rejection from the parent, the overwhelmed and rejecting parent goes FURTHER away when the child seeks involvement – the child’s demands for parental involve INCREASE the emotional distance of the parent.

The child of the rejecting and overwhelmed parent learns to become low-demand and self-sufficient in order to keep the overwhelmed and rejecting parent as close as possible.  This is the low-demand attachment bond the child has with the allied narcissistic-borderline (potentially dangerous and rejecting) parent.  With the narcissistic parent, the child’s low-demand requires the child to remain self-sufficient and provide the parent with narcissistic supply of approval, and for the borderline parent the child’s low-demand requires frequent emotional bonding displays to reassure the parent of the parent’s continuing value.

The low-demand characteristics of an anxious-avoidant attachment are often misinterpreted by the public and non-knolwedgeable mental health people as being the child’s mature self-sufficiency.   That is NOT true.  The child is absent normal-range motivations for bonding, they are being suppressed, and the low-demand of the child actually represents a symptom of attachment pathology – an insecure attachment to an overwhelmed and rejecting parent.

Court-Involved Family Conflict:   The children in court-involved family conflict are clearly NOT low-demand, easy, and compliant with the targeted parent.  A low-demand, low-protest anxious-avoidant attachment is not the insecure attachment display of children toward the targeted parent in court-involved family conflict.

Anxious-Disorganized Attachment:  This category of insecure attachment is the most severely pathological.  In this type of insecure attachment, the child is unable to develop any coherent strategy for bonding to the parent.  The parent who creates a disorganized child attachment system is typically a parent who is simultaneously a source of danger AND a source of nurture to the child, creating a mixed double-bind for the child of both intense avoidance motivations regarding the dangerous aspects of the parent, and intense bonding motivations from the nurturing aspects of the parent.  In response to intense and competing motivations to simultaneously flee and to bond, the child is unable to develop any coherent strategy to form a secure attachment bond to the parent – resulting in the display of non-functional – disorganized – child relationship responses.

Court-Involved Family Conflict:  In court-involved complex family conflict, a disorganized attachment was likely the insecure attachment category for the current narcissistic-borderline parent during their childhood in their bonding to their parent, creating their narcissistic and borderline personality pathology as an adult.  Aaron Beck describes this type of parent-child bond that leads to disorganized attachment and personality disorder pathology,

From Beck:  “Various studies have found that patients with BPD [borderline personalty disorder] are characterized by disorganized attachment representations (Fonagy et al., 1996; Patrick et al, 1994).  Such attachment representations appear to be typical for persons with unresolved childhood traumas, especially when parental figures were involved, with direct, frightening behavior by the parent.  Disorganized attachment is considered to result from an unresolvable situation for the child when “the parent is at the same time the source of fright as well as the potential haven of safety” (van IJzendoorn, Schuengel, & Bakermans-Kranburg, 1999, p. 226).” (Beck et al, 2004, p. 191)

Note the citations by Aaron Beck to Fonagy and to IJzendoorn.   Both Fonagy and IJzendoorn are prominent researchers in attachment, and their body of work is essential reading for all court-involved mental health professionals working with complex attachment-related pathology surrounding divorce.

A child rejecting a parent is an attachment-related pathology.  The attachment system is the brain system that governs all aspects of love and bonding throughout the lifespan, including grief and loss.  A child rejecting a parent is a problem in the love and bonding system of the brain – the attachment system.  A child rejecting a parent is an attachment-related pathology.  The research by Fonagy and IJzendoorn is essential and required reading for all mental health professionals working with attachment-related family pathology.

All mental health professionals working with court-involved attachment-related family pathology MUST possess a professional-level knowledge for the attachment system, what it is, how it functions, and how it dysfunctions.   This knowledge includes reading: Bowlby, Ainsworth, Sroufe, Lyons-Ruth, Fonagy, and IJzendoorn – including the Handbook of Attachment: Theory, Research, and Clinical Applications by Cassidy and Shaver.

Ignorance about the attachment system when working with attachment pathology is NOT acceptable professional practice.   Ever.  Ignorance of autism pathology is not acceptable when working with autism, ignorance of schizophrenia is not acceptable when working with schizophrenia, ignorance of eating disorders is not acceptable when working with eating disorders.  Ignorance is a violation of Standard 2.01a of the APA ethics code – and it is NEVER acceptable professional practice.

To be entirely clear:  All mental health professionals working with attachment pathology must possess a professional level knowledge for the attachment system, what it is, how it functions, and how it dysfunctions.  This includes reading Bowlby, Ainsworth, Sroufe, Lyons-Ruth, Fonagy, and IJzendoorn – and the Handbook of Attachment: Theory, Research, and Clinical Applications by Cassidy and Shaver.  Professional ignorance is NOT acceptable professional practice, and is a violation of Standard 2.01a of the APA ethics code.

If harm is then done to the client parent or child because of professonal ignorance, this would represent a violation of Standard 3.04 of the APA ethics code.

Neuro-Development

The attachment system is a goal-corrected primary motivational system of the brain.  It  developed across millions of years of evolution because of the survival advantage to children provided by bonding to their parents.  The attachment system has its neurological origins in the “imprinting” systems of earlier species (Lorenz) – baby ducks follow mommy duck – that’s the attachment system in a duck – called “imprinting.”  Baby zebra gets close to mommy zebra for protection from hyenas and lions – that’s the attachment system in a zebra.

Bowlby describes all of this in his first volume: Attachment. 

Humans are more complex social animals with more complicated brains to wire-up than ducks and zebras.  Our attachment systems are more complex than the attachment systems of zebras and the imprinting of ducks, but its source is the same and it is a foundational – primary – motivational system in the brain; meaning at the same level as the other primary motivational systems for food and sex, a basic built-in motivational system to bond to the parent.  The attachment system confers significant survival advantage.  It functions in characteristic ways; it dysfunctions in characteristic ways.

The attachment system is a brain system, a neurologically based primary motivational system of the brain that evolved for protection of children from predators (and from other environmental dangers like abandonment and starvation).  Children do not reject parents.  Ever.

From Bowlby: “The biological function of this behavior is postulated to be protection, especially protection from predators.” (Bowlby, 1979, p. 3)

Research on Attachment

The basic neural wiring of the attachment system develops during childhood, after which we then use the wiring patterns of our attachment networks throughout our lifetimes to organize our basic expectations and our approach to relationships, our object relations, our internalized representations of ourselves and of others.

We acquire and use our attachment patterns in a similar way as we acquire and use the patterns in our language systems. 

Language Acquisition:  Our brains anticipate that we will be learning language and our brains have specific areas and networks already set up to receive language (called “experience-expectant” development).  We then acquire the grammar of language during the period of early childhood, ages zero to five, and the specific language we learn is based on what we hear, French, Chinese, English (that’s called “experience-dependent” development). 

We then USE language throughout the rest of our lives in our communication and regulation of our social interactions. 

Same for our attachment networks. 

Attachment Pattern Acquisition:  The brain is already prepared to form relationship bonds, with networks ready to receive patterns governing expectations about self and other – called our “internal working models” of attachment (experience-expectant brain development).  We then acquire the specific “grammar” of our attachment system during early childhood, the specific patterns of our attachment networks are created through the specific experiences of the parent-child bond during childhood (experience-dependent).

We then USE these patterns of attachment specific to our expectations and history to then guide all of our future intimate relationships throughout the rest of our lives.

The formative period for language is early childhood, we then use language throughout the rest of our lives to regulate our social interactions.  The formative period for our attachment system is early childhood, we then use our attachment patterns the rest of our lives to regulate our social interactions.

Because the attachment system is glowing active and white-hot during infancy and early childhood, the research people in professional psychology – led by Ainsworth and the experimental paradigm she created for studying attachment behaviors – went to work researching the attachment network’s development in infancy and early childhood.  The heavy-duty neurological research began in the 1980s, led by Stern and Tronick, with others (Trevarthan’s research is notable, as is Beebe’s on the dyadic coordination of psychological states).

While the study of the attachment system focuses on early childhood, what we learn is applicable across the lifespan.  Humans don’t suddenly “switch-out” our attachment networks at adolescence.   We live in the same brains as adults as were neuro-developmentally created in our childhood.  Same brain, same attachment structures.  What we learn about the attachment system’s development in early childhood research is applicable across our lifespans.  Same brain, same brain structures, same neural organizations.

Our “internal working models” for our expectations, and our “internal working models” for interpreting and responding to communications in intimate relationships, are engraved into the neural wiring of our brain’s attachment networks during childhood, in the same way as our language networks are, through a dance of experience-expectant and experience-dependent growth and development across childhood.

The two grand kahunas of this early childhood research are Daniel Stern (amazing research) and Edward Tronick (amazing research).  Their work dovetailed into what the adult object relations psychoanalysts were discovering (Kohut, Stolorow) regarding a shared psychological state and the key role of modulated failures in parental empathy in healthy child development.  The research by Stern and Tronick also merged into the neurological research that has been developing at an ever accelerating pace following the advent of PET scans and fMRIs in the 1980s.

Neuro-developmental research on attachment really started to take off exponentially around 2000.  In 1994, a psychoanalyst, Alan Shore, wrote a full and rich neurological treatise on the socially-mediated neuro-development of the brain’s networks for emotional regulation.

Schore A.N. (1994). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development. Hillsdale, NJ: Erlbaum.

These advancing developments in the neuro-science of the parent-child relationship are summarized by Siegel in his book,  The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are.  Notice in the title how he emphasizes that our brains are shaped by relationships.  Cozolino also provides another summary of this neuro-developmental relationship research in his book, The Neuroscience of Human Relationships: Attachment and the Developing Social Brain.  Notice again, how he also emphasizes the role of relationships in the developing “Social Brain.”

As the research on the attachment system grew in the 1980s, a second, related but distinct, relationship system was discovered.  It was called “intersubjectivity” because that’s the construct for the shared-mind state that’s used in the world of adult psychoanalysis (Stolorow). 

The research on attachment has identified a second relationship system, in addition to attachment. It is a psychological connection system that creates a shared-mind state, called an intersubjective field, or when there are multiple people, and intersubjective matrix of shared experience.

From Stern:  “Intersubjectivity is a condition of humanness.  I will suggest that it is also an innate, primary system of motivation, essential for species survival, and has a status like sex or attachment.” (Stern, 2004, p. 97)

From Stern:  “Our nervous systems are constructed to be captured by the nervous systems of others.  Our intentions are modified or born in a shifting dialogue with the felt intentions of others.  Our feelings are shaped by the intentions, thoughts, and feelings of others.  And our thoughts are cocreated in dialogue, even when it is only with ourselves.  In short, our mental life is cocreated.  This continuous cocreative dialogue with other minds is what I am calling the intersubjective matrix.” (Stern, 2004, p. 76)

Tronick referred to this shared psychological state as a, “dyadic state of consciousness”

From Tronick:  “When mutual regulation is particularly successful, that is when the age-appropriate forms of meaning (e.g., affects, relational intentions, representations) from one individual’s state of consciousness are coordinated with the meanings of another’s state of consciousness — I have hypothesized that a dyadic state of consciousness emerges.” (Tronick, 2003, p. 475)

The “intersubjective” state described in the neuro-developmental research of a shared psychological fusion of experience (a “dyadic state of consciousness”) is similarly captured by the the family systems construct of “enmeshment,” exactly the same constructs identified in a different school of psychology, now provided with a neurologically understood foundation.

Shared Constructs:  In the psychoanalytic school, the construct is “internal working models” of attachment (Bowlby); in the cognitive-behavioral school, the construct is “schemas” (Beck).

Internal working models (Bowlby) = schemas (Beck).  Same construct, different schools.

Shared Constructs:  In the psychoanalytic school, the construct is intersubjectivity – a “dyadic state of consciousness” (Stern, Tronick); in the family systems school, the same construct is described as “enmeshment” (Minuchin; Bowen).

Intersubjectivity, “dyadic state of consciousness” (Stern Tronick) = enmeshment (Munchin, Bowen)  Same constructs, different schools.

They are all identifying the same thing, it is a common, scientifically based, lots of research studies, neurologically identified pathways, understanding for how the brain works in forming relationships and regulating emotions.  Right orbital prefrontal cortex.

Shore, A.N. (1996). The experience-dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of developmental psychopathology. Development and Psychopathology, 8, 59-87.

Mirror Neurons

Then, in the early 2000s, Italian researchers discovered a set of brain cells called “mirror neurons” that duplicate in us (mirror inside us) what someone else is experiencing.  This is the brain network that allows us to feel personally the emotions the actor in a movie is portraying.  We feel the emotions of the actor in the movie as-if it were our personal emotional experience.  Mirror neurons.

Iacoboni, M., Molnar-Szakacs, I., Gallese, V., Buccino, G., Mazziotta, J., & Rizzolatti, G. (2005). Grasping the intentions of others with one’s own mirror neuron system. Plos Biology, 3(3), e79.

This discovery merged into the research on attachment and intersubjectivity – the “dyadic state of consciousness” described by Tronick, and it united with the neurological research described by Shore.

From Stern:  “We experience the other as if we were executing the same action, feeling the same emotion, making the same vocalization, or being touched as they are being touched.” (Stern, 2004; p. 79).

Of prominent note is that research on mirror neurons has found that they are designed to read the INTENTION of other people – what’s motivating their actions.

From Stern:  “The discovery of mirror neurons has been crucial.  Mirror neurons provide possible neurobiological mechanisms for understanding the following phenomena: reading other people’s states of mind, especially intentions; resonating with another’s emotion; experiencing what someone else is experiencing; and capturing an observed action so that one can imitate it — in short, empathizing with another and establishing intersubjective contact.” (Stern, 2004; p. 78)

The constructs in court-involved family conflict of “coaching” and “brainwashing” are more accurately and professionally described from the neurological research on intersubjectivity as the social “cocreation” of a “dyadic state of consciousness,” and the child’s mirror neurons reading the intention of the parent, i.e, what does the allied parent WANT the child to do – mirror neurons read the intention.

Siegel: Mirror Neuons in Depth Video

In the mid-2000s, it all came together, clouds parted and the angels sang.  We’ve got it.  We understand how things work – in the relationship systems, and extending out into the emotion regulation systems and the behavior regulation systems – a dyadic regulation of emotions and behavior in the intersubjective “breach-and-repair” sequence (Tronick).

Tronick: Still Face; breach-and-repair sequence

The breach-and-repair sequence identified by Tronick and described extensively through his research is the core central unit of analysis for parent-child conflict.  All mental health professionals dealing with any aspect of parent-child conflict MUST understand the breach-and-repair sequence.  It is essential to the healthy emotional and psychological development of the child.

From Tronick:  “Unlike many other accounts of relational processes which see interactive “misses” (e.g., mismatches, misattunements, dissynchronies, miscoodinations) as indicating something wrong with an interaction, these “misses” are the interactive and affective “stuff” from which co-creative reparations generate new ways of being together (Cohn and Tronick, 1989; Tronick 1989).  Instead there are only relationships that are inherently sloppy, messy, and ragged, and individuals in relationships that are better able, or less able, to co-create new ways of sloppily being together.” (Tronick, 2002c, d). (p. 477)

Parent-child conflict (the breach) is not a bad thing, and the absence of parent-child conflict (enmeshment) is not a good thing.  The critical feature of the parent-child relationship is that all breaches are REPAIRED.  Dr. Tronick compared the breach-and-repair sequence to the “good, the bad, and the ugly.”

The “good” is the everyday sort of flow to bonding and breaches, the “bad” is a breach caused by an empathic failure, the “ugly” is leaving a breach un-repaired.  The WORST possible thing we can do is leave a breach un-repaired – the “ugly” describted by Dr. Tronick.

So what does forensic psychology do?  Leave un-repaired breaches – the ugly – the WORST possible thing to do… they are doing it.  Because they are ignorant.  They know nothing about the attachment system, they know nothing about the neuro-development of the brain, they are doing EXACTLY the WORST possible thing they can do… leave an un-repaired breach to the parent-child bond.

Dr. Tronick’s research with the Still Face paradigm is an outgrowth of the attachment research, and his research would be considered to fall within the psychoanalytic school of professional psychology.

“Not Ready”

Parents and the court are repeatedly told by entirely ignorant mental health people that the child isn’t “ready” to receive the love of a parent, or that the child needs individual psychotherapy in order to be “ready” to recieve the love of a parent. 

That is complete rubbish.

That is ignorance of epic proportions, and that is EXACTLY the WRONG thing to do, to leave an un-repaired parent-child breach.  We want to fix the breach as quickly as possible.  A breach is fixed with the application of empathy – do you see how quickly the breach was fixed in the Still Face YouTube example provided by Dr. Tronick?  Immediately.

The attachment system is a goal-corrected motivational system – it ALWAYS maintains the goal of forming an attachment bond.  In the Still Face example, do you see how the child’s protest behavior was an “attachment behavior” designed to ELICIT the parent’s involement – NOT to sever the parent-child bond to punish the parent.  Protest behavior is an attachment behavior, the attachment system is a goal-corrected motivational system, it ALWAYS maintains the goal of forming an attachment bond.

The idea that the child is not “ready” to be loved by a parent is insane ignorant rubbish. 

Any mental health professional who says the child is not “ready” to be loved by a parent is an ignorant buffoon who should NOT be working with children.  It is a breach.  It is part of a vital – neuro-developmentally vital – breach and repair SEQUENCE – with three parents, the breach, the protest, and the repair… the good, the bad, and the ugly.

DO NOT leave the child in the ugly – in a non-repaired breach.  Repair the breach as QUICKLY as you possibly can. 

If you are a mental health professional and don’t know how to repair a breach in the parent-child relationship – you should NOT be working with breaches to the parent child relationship.  Learn attachment.  Learn Bowlby.  Learn Stern and Tronick.  Don’t work with children until you do.

Do NOT leave the child in an un-repaired breach to the parent-child relationship.  Ever.  Fix it.  As quickly as you can, preferably immediately.

If any mental health person says that the child is not “ready” to be loved by a parent or needs individual therapy in order to be “ready” to be loved by a parent, that mental health person is an ignorant buffoon who should NOT be working with children.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

My goodness, Karen Woodall is full of… nonsense.

Karen recently posted a blog about Fairy Tales and splitting that was kind of all over the place, but the central premise is that she’s some sort of expert on “splitting” and she’s sort of simultaneously discovering splitting and reporting on her discovery.

There’s so much nonsense being put forth, I need to address it.  But there’s so much to address, I’m going to do it in multiple posts.  This first one on just the general nonsense of her grandiosity, and then I’ll devote the second one to the more specific nonsense of what she says. 

Fairy Tales from the Woodalls

In her blog, Karen seemingly admits that her approach to understanding complex family conflict surrounding divorce is to create a fairy tale – a make-believe fairy talesstory she creates about a new form of pathology she thinks she’s “discovering.”

How exciting that must be for Karen, she thinks she’s discovering something.

But, for starters, Karen, I’m unclear which is the title for your blog?

Is it, Fractured Minds: Kaleidoscopic Thinking in Parental Alienation or is it the bigger banner of, Fairy Tales for Unwanted Children.  Or perhaps it’s both?  I think it’s both.

Karen, you are familiar with projective processes, right?  You are aware that everything we do is a projective statement about ourselves, not an actual statement about the world.  You do understand projective process, right Karen?

So the phrase “fractured minds and kaleidoscopic thinking” – does that refer to you, Karen?  Does that represent your inner experience as you struggle to psychologically hold onto your collapsing world of “parental alienation,” and is the other, Fairy Tales title, does that refer to the mythical story of pathology you’re creating as the grandiose defense of self against your collapse into obscurity and irrelevance? 

Are both titles true, Karen?  The split inside you?  And what are you writing about?  Splitting.  You are familiar with projective processes, right Karen?

I suspect both titles are true, Karen.  You appear to be manifesting an inner splitting of yourself, right before our very eyes, Karen.  How cool is that, you’re talking about splitting at the same time you’re projectively manifesting your own split. 

Inside, your world is a kaleidoscope of fractured thinking, a fractured mind, and to cope, to hold your world together, you’re creating a psychological Fairy Tale of being an “expert” discovering a “new pathology” – how exciting for you, Karen… a new pathology.  Do you think you’ll get the Nobel prize for your discovery?  Seriously.  You’re discovering a whole new pathology, Karen.

Aren’t you?  Of course you are.  What do you call it?  Right, “parental alienation.”  Oh, you’re not inventing it?  This Richard Gardner guy discovered it, huh.  And now you’re on this fantastic journey of discovery too.  Wow.  That’s great, Karen.  A narcissistic paradise.  Can anyone play?  Can I play too?  Any rules, or can I just make up anything I want about this “parental alienation” thing?

Far as I can tell, there’s no rules here at all, are there Karen?  You just have to self-identify as an “expert” in this new pathology and, there ya go, you’re now an “expert” and can start making stuff up, whatever you want.  Or is there some sort of “experts” club that you have to join?  Is there a club, Karen?  Some sort of certificate you need to have bestowed on you before you become an “expert” – like the Free Mason’s or Shriners or something, some candlelight ceremony with people dressed in togas?

How is it that exactly, that you’re an expert?  Is that just a self-designation thing? 

Or is it sort of like wishing Tinker Bell back to life, “I do believe in fairies, I do believe in fairies…” is that the way it works?  I am an expert, I am an expert.  Is that how we develop new pathologies in professional psychology, Karen?  Somebody says, “I’m an expert” and proposes a new pathology, and then everyone goes, “Okay” and we have a new pathology.  Is that the way it works, Karen, in the Fairy Tales?

So how should we handle that, Karen?  When someone… like you or Gardner… propose the existence of a whole new form of psychopathology that is supposedly unique in all of mental health… how should we handle that?  In professional psychology, how should we handle that?

Should we just say, “Okay” to everyone who proposes a new form of pathology?  No, of course not.  So how do we handle that then, eh Karen?

Do you know how we handle that in professional psychology, Karen, when someone proposes a new pathology?  We say, “Show us the research base for the proposal.”  That’s what we say.  And when we say, “research base,” we mean like autism-level, ADHD-level, PTSD-level, attachment-level, schizophrenia level research.  If you’re asking for a whole new pathology… that’s an autism-level/schizophrenia level research base we’re looking for to support a “new pathology.”

So… do you have that research base for your pathology, Karen, this “parental alienation” thing you’re proposing?  Amy Baker and a smattering of poorly designed “studies”?  That’s it, Karen?  Okay, no worries, you keep working on it.  In the meantime, Karen… your pathology, your “parental alienation” thing that you’re proposing… it doesn’t exist as a real thing.

That’s how it works, Karen.  Oh… but you’re special.  We should skip all that for you, because you’re an “expert.”  So we should just do without the research base – and a coherent description of the pathology, and we should just accept whatever you say… because… you’re an “expert.”  I know you’re an “expert” because you say so, and that’s how we can tell who the “experts” are… they tell us they are.  That’s so helpful.

It’s a unicorn, Karen.  Your “parental alienation” pathology.  A Fairy Tale. I know you like your stories, your Fairy Tales.  They’re simple and easy to understand, because you just make up the story to be whatever you want it to be.

But Karen, just saying – “It’s a pathology, it’s a pathology” over and over like a petulant 3-year-old is not how we adopt new forms of pathology in professional psychology.  You can imagine the chaos that would create.

Why, somebody might come up with a Carrot Rejection Syndrome (CRS) for all we know.  The child engages in a campaign of denigration toward carrots, rejecting carrots for weak and frivolous reasons.  The child shows a lack of ambivalence regarding carrots.  Their rejection of carrots spreads to other related vegetables, like broccoli and peas.  Oh… and here’s a good one, the independent rejecter phenomenon, the child claims that their hatred of carrots is not being influenced by the other kids at school not liking carrots, that it’s the child’s own beliefs… carrots are yucky.  Carrot Rejection Syndrome.

And you know, Karen, kids with Carrot Rejection Syndrome show this splitting thing where carrots are all-bad and pizza is all-good.  Wow, you should look into that, Karen.  You’re an expert in splitting.  Carrots are all bad, pizza is all good.  Splitting, right?

But that’s silly, right Karen?  We don’t just go around making up new pathology at the drop of a hat for any old thing… Carrot Rejection Syndrome, a campaign of denigration toward carrots for weak and frivolous reasons.  Sheesh, nobody is going to just make up a new syndrome like that, Carrot Rejection Syndrome.  Any real mental health professional will first do the work of collecting the research data – like for PTSD when they added that as a pathology. 

No one just goes around making up new forms of pathology entirely on their own with NO research support and expecting everyone to accept it, because then we’d have a thousand types of Carrot Rejection Syndromes.  Homework Refusal Syndrome – a campaign of denigration toward homework for weak and frivolous reasons, a lack of ambivalence toward homework, an absence of guilt about not doing homework, the presence of borrowed scenarios (the dog ate my homework).

So obviously, we can’t have that, right Karen.  I know my examples might seem outlandish – Carrot Rejection Syndrome, Homework Refusal Syndrome – I mean, seriously, no one would be so unprofessional and insane to propose something THAT stupid, but it’s the principle, Karen.  If people can just go around being self-proclaimed “experts” and making up any old pathology they want willy-nilly… things could get out of hand quickly.

So what was that pathology of yours again, Karen?  Parent Rejection Syndrome?  Was that it?  Parent Refusal Syndrome?  I forget.  Anyway, in order to have a pathology accepted in professional psychology… you need a research base for the proposal.  And that’s a research base like for autism, or PTSD, or attachment.

Now because professional psychology deals with real pathology, Karen, I’m going to ask you to please stop using your position as a mental health person to mis-inform people about professional psychology.  You are deceiving people, Karen.  There is no new form of pathology, Karen. 

“Yes there is”?  Well then, Karen, show me the research base for your “new pathology” proposal.  See how that works?  No Carrot Rejection Syndromes.  Research base, Karen.  Autism-level, attachment-level, PTSD-level research base.   Until then, Karen, your “new pathology” doesn’t exist.

You like Fairy Tales, don’t you Karen.  You remember Pinocchio?

Remember the Fox and Cat at the crossroads, who convince Pinocchio to go to Pleasure Island instead of going to school, and the cricket says, “No, no, Pinocchio, go to school” but theSlide7 Fox and Cat tell Pinocchio, “Don’t listen to the cricket, Pleasure Island is wonderful.”  And then Pinocchio goes to Pleasure Island and gets turned into a donkey, and is sent to the salt mines and has to be rescued by the Blue Fairy.  You remember that Fairy Tale, don’t you Karen?

Well you and the Gardnerian “experts,” Karen, are the Fox and Cat at the crossroads.  You’re telling all these parents to go the bad way, the way of tragedy and no solution, telling them that they have to prove “parental alienation” to a judge, in court, at trial.  No, they don’t. 

I’m like the cricket, telling people to “Stay on the path of established knowledge, go to school Pinocchio; Bowlby, Minuchin, Beck – don’t go to “Parental Alienation” Island Pinocchio, you’ll be turned into a donkey and sent into the family court system, and then you’ll have to hope that the Dorcy will come to rescue you from the family courts.”

The Fox and the Cat never should have told Pinocchio to go to “Parental Alienation” Island.  The cricket was right.  Parents who went that way were turned into donkeys and sent to the family courts.  Lucky for Pinocchio that the blue fairy came.  I hope Dorcy’s able to get you out of the salt mines and turn you back into a person instead of a donkey.  But you shouldn’t have listened to the Fox and Cat.

Pinocchio should have gone to school, like the cricket said, and studied, and applied knowledge.  But instead he went running after the easy path, the one the Fox and the Cat told him would be a good thing.  They lied to Pinocchio. The Fox and the Cat did a very bad thing to Pinocchio.

They tell parents, “Don’t listen to the cricket, Pinocchio, don’t apply knowledge, come to “Parental Alienation” Island instead, you’ll play all day in the Funhouse of Experts.  You’re leading them astray, Karen, the parents.  That is a bad thing to do.  You know “Parental Alienation” Island is a sham, it just funnels parents and families into the family court system.  You know it offers no solution.  You know that, Karen.

Yet you tell people to go to “Parental Alienation” Island,  Shame on you Cat.  You know that “parental alienation” offers no solution to parents. 

But you know something, Cat?  AB-PA is designed to expose the allies of the pathology.  And it works.

All I’m advocating for is a return to Bowlby, Minuchin, Beck, the established knowledge of professional psychology.  You’re against that, “Don’t listen to Dr. Childress – don’t listen to that cricket on your shoulder telling you to apply the established knowledge of professional psychology.”

Who could possible argue AGAINST the application of established knowledge?  Someone who doesn’t want a solution, the pathogen’s hidden allies.  You, Karen.

Here, I’ll show you Karen… stop using the term “parental alienation” and rely ONLY on the established knowledge of professional psychology.  “No.”  See?   You.  You are arguing AGAINST the application of established knowledge.  Why are you doing that, Karen?  Oh, because you don’t actually want a solution, you just want to LOOK like you want a solution.

A Vanishing Expertise

Tell me, who says you’re an “expert” Karen?  You do. 

Wait, I’ll bet Bill Bernet does too, doesn’t he.  He says you’re an “expert.”  But wait, who says Bill Bernet is an “expert”?  Oh, you do.  I get it.  You all just go around anointing each other as “experts” and then just make stuff up.  Sweet.  You know that’s a scam, right?  You’re not a real expert in anything.  You know that, right?

You are?  You are really an “expert” for real?  Okay, show us.  On your vitae.  Post your vitae, Karen.  Show us how you developed your expertise. Where did you receive your training in the attachment pathology?  Where did you receive your training in family systems therapy? Where did you receive your training in personality disorder pathology?  Where did you receive your training in complex trauma? Where did you receive your training in the neuro-development of the brain during childhood?

You’re not an expert in anything, Karen, except in your own imagination and fantasies.  It’s a Fairy Tale, Karen.

I suppose in Fairy Tales that’s all it takes, isn’t it Karen, a wave of the magic wand and, presto-chango, Karen Woodall is an “expert” who goes to the royal ball in her magical carriage of “parental alienation” dressed in her beautiful “expert’s” dress– ahhh, if only… what a nice fantasy, isn’t it Karen.  If only everyone listened to you and did what you told them to do, then the world would be wonderful, wouldn’t it Karen?  If everyone just listened to you and did what you said.

Thank you from all of us, for your magnificence, Karen.  Whatever would we do without your magnificent brilliance.  We’re so lucky to have “experts” like you to guide us in our ignorance.  How’d you become an expert again?  Can we look at your vitae?  No?  How odd.

But alas, they don’t listen to you, do they Karen?  And never will, Karen. 

So I guess we will be lost forever in the wilderness, because no one is listening to Karen Woodall, our savior.  That’s the storyline, isn’t it Karen?  It’s the “If Only” story, isn’t it?  If only people listened to me, the world would be a better place.  That story.  You’ve also got the Star Wars mythos going too, right, the heroic rebel alliance fighting the evil empire, a never ending struggle of the heroic rebels fighting against the Death Star.  Isn’t that the one?  If only Karen Skywalker can destroy the Death Star in time to save us.  Save us, Karen.  We’re all counting on you, please save us Karen. 

Isn’t that the storyline you’re running?

If only everyone listened to your magnificence.  Ahhh, that would be lovely.

Your world of “parental alienation” is disappearing, Karen – it’s going to be solved.  Really.  We’re on the path to solving this family conflict pathology using Bowlby, Minuchin, and Beck… no Gardner.  Which means… no you. 

Uh-oh.  What will you do, Karen?  When there is no “parental alienation”?

Because… you’re not really an “expert” in anything except a pathology that you can simply make up, when that pathology goes away… you won’t be an “expert” anymore.  What will you do, Karen, once the pathology is solved? 

You’ve gotten locked into a rigidity that you can’t escape.  You must, at all costs, hold on to the term “parental alienation” or else you… cease to be an expert in anything.  Uh-oh Karen.  What are you going to do as “parental alienation” fades from relevance in professional psychology?

No one’s ever going to say, “Hey, we should give this Gardner PAS a new look.”  Read the writing on the wall, Karen.  You, Karen Woodall, are everything status quo – Gardnerian PAS – you are no change, just more of the same – 40 years of the same, Karen.  Forty years of no solution, Karen. 

Uh-oh when change comes and the status quo is washed aside.  What happens to you, Karen, when the source of your sole “expertise” disappears?

Dr. Childress is taking it away from you, isn’t he, your prized “expertise.”  I’m leading everyone back to Bowlby, and Kernberg, and Minuchin.  Away from you.  Fight back, Karen.  Hold on.  Stop him, Karen, stop him from leading people back to the established principles of professional psychology… because then they won’t listen to you, and you won’t be… important.

That must be hard for you, Karen.  To see your role as an “expert” vanishing along with the construct of “parental alienation.”  You have so much of your ego tied up in being an “expert.”  What happens when the pathology is solved?  What happens when it’s solved without the construct of “parental alienation”?

Will you be happy, Karen, when the pathology is solved using Bowlby, Minuchin, and Beck, will you be happy?  Or will you be sad and unhappy when the pathology is solved and families are reunited?  What will you do when you’re not an “expert” anymore, when no one listens to you? 

I tried to warn you, change is coming, we’re solving the pathology.  I told you, I’m taking the field of professional psychology back to the standard and established – already scientifically established – knowledge of professional psychology – Bowlby, Minuchin, Beck. 

Family systems therapy solves everything about this pathology, Karen.  Why aren’t you using family systems constructs?  Oh, because then YOU are not the expert, Minuchin and Bowen are.  Why do we need the construct of “parental alienation,” Karen?  What’s wrong with using cross-generational coalition and emotional cutoff from family systems therapy?  Oh, because then YOU are not the expert, Minuchin and Bowen are.

We MUST hold on to “parental alienation” – we MUST, we MUST.  No, Karen.  That construct is going away in professional psychology.  Oh, it will remain a construct in the general population, people prefer simple easy-to-understand things.  But in professional psychology… we’re returning to the established constructs and principles of professional psychology.

Dr. Childress isn’t going anywhere, Karen.  We are returning to Bowlby, Minuchin, Beck, that is a fact.  You will become irrelevant once we drop the construct of “parental alienation” and once we return to the established knowledge and constructs of professional psychology, that too is a fact.

Once we leave the make-believe world of “discovering” new pathology – once we leave the Fairy Tale world of Alice through the Looking Glass, where professional expertise is self-anointed, once we return to the real world of real pathology, we will solve the pathology.

No mermaids, Karen.  No unicorns.  I know you love your mermaids and unicorns, I’m sure they’re magical and make you feel warm and safe.  But that fantasy is not real, Karen.  There is no new pathology, Karen.  It’s a delusion of grandeur.  The world you’ve constructed for this new form of pathology, this “parental alienation” pathology you like so much… that’s not real.  It’s an illusion.  It’s a Fairy Tale, Karen.   A creation of your fantasy.

I know, it’s a beautiful fantasy, to be an “expert” – so important, everybody listens to you.  But the reality is, you’re not important, Karen.  You’re not an “expert” in anything, that’s simply your egoistic hubris and your unbridled grandiosity.  There is no new pathology you’re discovering.  You’re an ordinary person, ignorant in many ways, over your head, beyond your capacity.  The emptiness of your grandiosity will be deflating with the coming of reality.  I’m sure that’s hard on you, watching your world vanish.  I’m sure inside, it must feel like a kaleidoscopic and fracturing world.

You’re not an expert in anything, Karen. 

“Yes I am” – Okay, let’s see your vitae.  Post your vitae, Karen.  You’re the one asserting that you’re an “expert,” so, back it up, post your vitae.  My vitae is up online, where’s yours?

Dr. Childress Vitae

Dr. Childress YouTube Vitae Series

You are not an expert in anything, Karen.  You just want to be.  You want to be more than your are, more important, more special… everybody needs to listen to Karen… she’s important.

No, Karen.  You’re simply an ignorant person who thinks she’s “discovering” something.  You’re just making stuff up to hide your ignorance. 

Is it to hide your laziness, Karen?  Is that it?  Are you simply too lazy to learn and apply knowledge?  Or is it that you’ve tried to learn the material of Bowlby, Minuchin, Beck et al., and you don’t understand it?

Is that it, Karen?  Is it that you don’t comprehend the information from family systems therapy and complex trauma?  Personality disorders and attachment pathology?  Is it that you don’t comprehend the information?

That’s it, isn’t it?  That’s why your mind feels like a kaleidoscope of fractured thoughts.

Where did you receive your training in attachment pathology, Karen?  My vitae is available for all to see.  Where’s yours?  You’re an “expert” – let us marvel in your expertise.  Post your vitae, let’s have a look at exactly how much of an “expert” you truly are.

Hurting People

I wouldn’t have much of a problem with your grandiose arrogance, Karen, except that it hurts children and their parents.  Your ignorance and your misdirection of parents into paths that offer no solution whatsoever, hurts people.  You’re hurting people, Karen, by withholding the solution from them.

Are you diagnosing DSM-5 V995.51 Child Psychological Abuse, Karen?  It turns on Diagnostic Indicator 3, the persecutory delusion.  Is that present, Karen?  A persecutory delusion in the child?  If it is, that’s a DSM-5 diagnosis of V995.51 Child Psychological Abuse.  Add attachment system suppression and five personality disorder traits and the diagnosis of Child Psychological Abuse is a lock.  Are you diagnosing DSM-5 V995.51 Child Psychological Abuse, Karen?

You’re not are you?  Because you don’t want to assess for AB-PA because then Dr. Childress will be the “expert,” not you… so you are withholding the DSM-5 diagnosis of V995.51 Child Psychological Abuse – when it is an appropriate and warranted diagnosis – BECAUSE… you want to stay an “expert.”  That… is reprehensible professional practice for your clients, Karen. 

If you are not diagnosing V995.51 Child Psychological Abuse, Karen, please… tell us why you are not diagnosing this pathology as V995.51 Child Psychological Abuse?

You and I both know the answer, don’t we Karen.

Answer:  You are not diagnosing a DSM-5 V995.51 Child Psychological Abuse because the construct of “parental alienation” doesn’t actually support the DSM-5 diagnosis of Child Psychological Abuse, does it?   Because it is not a real pathology is it?  It’s only a pathology of your creation – you and Gardner, a Fairy Tale. 

The only way to reach a DSM-5 diagnosis of child abuse is through AB-PA, and you refuse to apply the established knowledge of professional psychology and you INSIST on using a made up form of new pathology, so the DSM-5 diagnosis is being withheld from your clients because of your ego and desire to be an “expert.”

That is morally reprehensible professional practice, Karen.

A Pathogenic Ally, A Split Mind

If you are the “fractured mind and kaleidoscopic thinking” of your title, which a reading of your blog with professional knowledge suggests, then I suspect your fracturing might be a response to stress, Karen.

The world of “parental alienation” – the world of your self-identify as an “expert” is disappearing, Karen.  You, as an expert, are disappearing too.  We all are.  Myself included.  The world of “experts” and “evaluators” is leaving, like the boats of elves leaving the world of men at the end of Tolkein’s Lord of the Rings, we’ll be sailing to the distant shores.  We won’t need “PAS experts” or “custody evaluators” anymore.  That’s a narcissistic approach that leads to no solution.

The world of clinical psychology is returning – Bowlby, Minuchin, Beck, van der Kolk, Tronick.  The real world.  No Fairy Tales anymore.

I’m leaving too, once my job here is done.  That’s what clinical psychologists do, we work ourselves out of a job by fixing things.  Dr. Childress never was an expert.  I’m just a clinical psychologist.  I’m solving the pathology.  I’m working, Karen.  You are watching a clinical psychologist at work.  In this blog too, I’m working.  I’m disabling an ally of the pathogen from causing further damage.

You are a pathogenic ally.  You know that don’t you, Karen?  Let me ask you this, who wants to stop Dr. Childress?  The allies of the pathology, right?  The allied parents, their attorneys, their flying monkeys.  And you.  You and Bill Bernet, and Amy Baker, Dr. Miller.  You, the Gardnerian PAS group, you want to stop Dr. Childress too right?   “How can we stop Dr. Childress,” you’ve had those discussions.

The pathogen wants to stop a return to established constructs and principles of professional psychology, and YOU want to stop a return to the established constructs and principles of professional psychology.  You and the pathology are on the same side, Karen.  You are allied with the pathology AGAINST a solution.

Here, I’ll prove it… Karen, stop using the construct of “parental alienation” and ONLY use the established knowledge of professional psychology.

Karen’s Response: “No, Dr. Childress.  I insist on creating a new form of pathology and advocating that everyone else adopt my new pathology, based on the work of my guru, Richard Gardner.”

Karen… you do understand how the projection thing works in psychology, right?  Everything you do – everything, Karen… is a projection of your inside stuff.  I’m a clinical psychologist, Karen.  You know I can see your inside material, right?  That “guru” thing you accuse me of… well, reality is that I’m saying it’s not me, Karen, it’s Bowlby, Minuchin, Beck.  You’re the one saying it’s you – you’re the one claiming to be coming up with new forms of pathology and new forms of therapy.  You’re the guru, Karen. 

And your guru is Richard Gardner.  You think in terms of “experts”- that’s YOUR organizing cognitive-relational structure.  You see gurus, like Gardner, like yourself.  So when you look at me, you see your reflection.  You do understand how projection works, right Karen?

I’m a clinical psychologist.  I’m working.  I’m solving pathology.  When I’m done, I’ll be out of a job.  Yay.  Then I’ll move on to the next client.  I’m a clinical psychologist.  I fix things.  That’s my job.  It wasn’t my mind that organized a return to the established knowledge as some sort of “guru” thing – that’s your mind that sees that, Karen – mirror, Karen, mirror. 

Karen, I’d be worried if I ever found myself on the same side of something as this pathology.  If you’re on the same side of the pathology as the narcissistic-borderline parent in trying to delay and prevent a solution… then you are an ally of the pathology. See how that works?

AB-PA – a return to the established knowledge of professional psychology – Bowlby, Minuchin, Beck – is designed to identify the allies of the pathogen.  Did you know that, Karen?  Yes, it is.  Who could possible argue AGAINST applying the knowledge of family systems therapy and the DSM-5?  You.  It identified you as the ally of the pathology.  You do not want to solve this, you want to keep this endlessly in conflict… so you can remain an “expert.”

Prove me wrong, Karen.  Advocate for a return to the established constructs of professional psychology – stop using the construct of “parental alienation” and rely ONLY on the established knowledge of professional psychology.

You won’t do it.  Oh hi, there you are, pathogenic ally.  I almost didn’t see you there.  You do such an excellent job of hiding.  I must say, that false conflict you created as the “loyal opposition” was quite convincing… up to a point.

You… are not an expert in anything, Karen.  You are simply grandiose.

Prove me wrong, post your vitae.  Show us where you received your training in attachment pathology, in family systems therapy, in personality disorders, in complex trauma, and in the neuro-development of the brain.

Or do you think you don’t need to know things?   Do you believe you can be ignorant, and that’s okay?

You’re the one claiming to be an expert, Karen.  Post your vitae.  I posted mine.

You’re not an expert in anything, Karen.  You know it, and I know it.  The only people who don’t realize your level of ignorance are the parents.  They trust you.  You betray them.  That’s not good, Karen.  You and the other Gardnerian “experts” are the Fox and the Cat at the crossroads.  Shame on you, Karen.  What you are doing is a bad thing to do.  It hurts parents and children.

From Aaron Beck:  “The core belief of narcissistic personality disorder is one of inferiority or unimportance.” (Beck et al., 2004, p. 249)

I imagine things are starting to get difficult for you as you see your supposed “expertise” vanishing into the illusion that it always was.  We are going to solve this pathology, Karen, and it’s going to be solved without the construct of “parental alienation.”  Where does that leave you, Karen, once the pathology is solved?

Will you be happy, or unhappy, Karen, when the pathology is solved, solved without “parental alienation” as a pathology?  What happens to your self-importance?   I suspect being average is going to be a hard adjustment for you.  After all, in the Fairy Tales of your creation you’re a magnificent “expert” who is on a magnificent “journey to develop new approaches to family therapy” – oh thank you, Karen.  God bless you Karen.  You’re so magnificent.

Thank God we have your magnificent “expertise” Karen, to lead us in the right way, your way, this new pathology thing that you think you’re “discovering.”

I’m sure it will solve everything… eventually… some day… maybe.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857